Individual provider Active NPI

Nicole Marie Allen, ARNP

  • Family Nurse Practitioner
  • Centralia, WA
National Provider Identifier
1972387090
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61478889 Issued in WA
Practice address
1800 Cooks Hill Rd Ste G
Centralia, WA 98531-9162
Phone
(360) 736-3042
NPI assigned
Aug 21, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61478889 WA Primary

Addresses

Primary practice location

1800 Cooks Hill Rd Ste G
Centralia, WA 98531-9162

Mailing address

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595

Other identifiers 1

IdentifierTypeStateIssuer
2258345MedicaidWA

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
I20231115002987 WA Practitioner - Nurse Practitioner 4981051729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 Cooks Hill Rd
Suite G
Centralia, WA 98531-9162
Phone (360) 736-3042

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61478889WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services CurrentSince Oct 16, 2023 Accepting new patients
Lewis County Community Health Services Current Accepting new patients
Lewis County Community Health Services CurrentSince Oct 16, 2023 Accepting new patients
Lewis County Community Health Services Past Accepting new patients

Locations

1800 Cooks Hill Rd
Ste G
Centralia, WA 98531
Phone (360) 736-3042

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

Interoperability endpoints

  • Direct secure messaging: nicole.allen.p1@direct.valleyviewhc.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1972387090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD STE G",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319162",
            "telephone_number": "360-736-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61478889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2258345",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

Verify at the official NPI Registry.