NICOLE SEVERTS (CNP) – Family Nurse Practitioner, NPI 1184161754
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for NICOLE SEVERTS (CNP)
PO BOX 2928
PORTLAND, OR 972082928
Phone: (425) 207-5155
Type: Mailing
11995 SE Sunnyside Rd
Happy Valley, OR 97015
Phone: (888) 227-3312
Fax: (971) 282-0083
Type: Location
The Box, Fargo Village, Lower Stoke, Coventry, West Midlands Combined Authority, West Midlands, England, CV1 5ED, United Kingdom
FARGO, ND 581086001
Phone: (701) 364-4222
Type: Mailing
800, Bemidji Avenue North, Bemidji, Beltrami County, Minnesota, 56601, United States
BEMIDJI, MN 566013054
Phone: (218) 308-2400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-12-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170130002264 | I | Nurse Practitioner | MN | TBD |
| I20211215000865 | I | Nurse Practitioner | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| Physician Assistant | FL | |
| Nurse Practitioner | OR | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | VA | |
| Physician Assistant | IL |
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