Active NPI
Alyce M. Huntsinger, FNP, NNP
- Family Nurse Practitioner
- Salem, OR
National Provider Identifier
1932310216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 200850051NP
- Practice address
- 2480 Liberty St NE
Suite 180
Salem, OR 97301-8380 - Phone
- (503) 363-8047
- Fax
- (503) 363-6571
- NPI assigned
- May 25, 2007
- Last updated
- Aug 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 200850051NP | OR | Primary |
| Neonatal Nurse Practitioner | 363LN0000X | 081047091N9 | OR |
Addresses
Primary practice location
2480 Liberty St NE
Suite 180
Salem, OR 97301-8380
Mailing address
2480 Liberty Street NE
Suite 180
Salem, OR 97301
Phone (503) 363-8047
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022927 | Medicaid | OR | |
| 9644345 | Medicaid | WA |
Other names 1
- Alyce M. Huntsinger-Mickel
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 081047091N9 | OR | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WVP Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Clinical Support Providers
- Community/Behavioral Health Agency
- Salem, OR
- NPI 1922583616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313366400000",
"number": "1932310216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 LIBERTY STREET NE",
"address_2": "SUITE 180",
"city": "SALEM",
"state": "OR",
"postal_code": "97301",
"telephone_number": "503-363-8047",
"fax_number": "503-363-6571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 LIBERTY ST NE",
"address_2": "SUITE 180",
"city": "SALEM",
"state": "OR",
"postal_code": "973018380",
"telephone_number": "503-363-8047",
"fax_number": "503-363-6571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTSINGER",
"first_name": "ALYCE",
"middle_name": "M.",
"credential": "FNP, NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2011-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "200850051NP",
"primary": true
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "OR",
"license": "081047091N9",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022927",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9644345",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ALYCE",
"last_name": "HUNTSINGER-MICKEL",
"middle_name": "M.",
"credential": "NNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.