Individual provider Active NPI

Jillian Louise Lotito, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chehalis, WA
National Provider Identifier
1962828715
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP 9325109 Issued in FL
Practice address
57 W Main St # 260
Chehalis, WA 98532-4815
Phone
(360) 261-6930
NPI assigned
Mar 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60920133 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201811044 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP 9325109 FL Primary

Addresses

Primary practice location

57 W Main St # 260
Chehalis, WA 98532-4815

Mailing address

1132 SW 13TH Ave
Portland, OR 97205-1703
Phone (503) 535-3800

Other practice location 1

1437 S Belcher Rd
Clearwater, FL 33764-2829
Phone (727) 524-4464 ext. 1259

Other practice location 2

1132 SW 13th Ave
Portland, OR 97205-1703
Phone (503) 535-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230301000473 WA Practitioner - Nurse Practitioner 1052544483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1707 Cooks Hill Rd
Centralia, WA 98531-9071
Phone (360) 261-6930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9325109FLMDPsychiatric/Mental Health Nurse Practitioner
201811044ORMDPsychiatric/Mental Health Nurse Practitioner
AP60920133WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Integrated Health Services, LLC CurrentSince Dec 28, 2022 Accepting new patients

Locations

1707 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 736-1965

57 W Main St
#260
Chehalis, WA 98532

1116 14th Ave
Longview, WA 98632
Phone (360) 623-5784

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1962828715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051703",
            "telephone_number": "503-535-3800",
            "fax_number": "503-223-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W MAIN ST # 260",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985324815",
            "telephone_number": "360-261-6930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1437 S Belcher Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337642829",
            "country_code": "US",
            "telephone_number": "727-524-4464 x1259",
            "fax_number": "727-210-6945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1132 SW 13th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972051703",
            "country_code": "US",
            "telephone_number": "503-535-3800",
            "fax_number": "503-223-6837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOTITO",
        "first_name": "JILLIAN",
        "middle_name": "LOUISE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60920133",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201811044",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP 9325109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.