NICHOLE PETTERSON FNP
NPI 1619386455
Nurse Practitioner - Family in Redmond, OR

Q: What is Nichole Petterson's NPI number?

The NPI number for Nichole Petterson is 1619386455. It was assigned to this individual provider in the NPPES registry on August 6, 2014. The provider is also known as Nichole Mitchell Fnp.

Q: What is Nichole Petterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Nichole Petterson was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 06, 2014PECOS EnrolledAccepts Medicare Assignment

1250 SW VETERANS WAY STE 120, REDMOND, OR 97756(541) 383-3005(541) 383-1883 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 17, 2023, Feb 4, 2020 (2 updates tracked since 2020).

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About Nichole Petterson Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLE PETTERSON FNP (NPI 1619386455) is an individual family provider in Redmond, Oregon, licensed in Oregon (202009378NP-PP) and active in the NPI registry since August 2014. She is enrolled in Medicare PECOS, is affiliated with St Charles Medical Center - Bend, and maintains a secondary practice location in Middletown.

NPPES Registry Identity

NPI1619386455

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameNICHOLE PETTERSONCredential: FNP

Location Address1250 SW VETERANS WAY STE 120Redmond, OR 97756-2588

Mailing Address600 Sw Columbia St Ste 6250Bend, OR 97702-1099 · (541) 383-3005 · Fax (541) 383-1883

Phone(541) 383-3005

Fax(541) 383-1883

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateAugust 6, 2014

Last NPPES UpdateJanuary 17, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 17, 2023

✔ NPI 1619386455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in OR · 202009378NP-PP✔ Licensed in CT · 5816

1250 SW VETERANS WAY STE 120, Redmond, OR 97756

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Other Names 1

Former Name (1)Nichole Mitchell Fnp

Secondary Practice Location 1

Location 1675 Main StreetMiddletown, CT 06457 · Phone (860) 347-6971

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nichole Petterson Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42537243

PECOS Enrollment IDI20211214002792

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

19 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Charles Medical Center - Bend

Acute Care Hospitals · Bend, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380047

Location2500 NE Neff RoadBend, OR 97701 · Deschutes County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97756 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY BESKAR PHARMD

Pharmacist