BETHANY L MADDEN (ARNP) – Family Nurse Practitioner, NPI 1104691658

BETHANY L MADDEN (ARNP) is a healthcare provider. based in Longview, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. AP61478800 (WA). The NPI Number for BETHANY L MADDEN (ARNP) is 1104691658

Main info

Female
3 Years Of Experience
Name
BETHANY L MADDEN (ARNP)
NPI
1104691658
Phone
(360) 636-3892
Address
1057 12TH AVE
Enumeration Date
15 November 2023
Last Update Date
18 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3606363892
Graduation Year
2023 (3 years ago)
PAC ID
0941659718
Group Practice PAC ID
5991696395
Professional Enrollment ID
I20231206001121
Address ID
WA986322509LO1057XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for BETHANY L MADDEN (ARNP)

  • 1057 12TH AVE

    LONGVIEW, WA 986322509

    Phone: (360) 636-3892

    Fax: (360) 414-1342

    Type: Mailing

  • 139 1ST AVE SW

    CASTLE ROCK, WA 98611

    Phone: (360) 814-2353

    Fax: (360) 274-7439

    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: 2023-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231206001121INurse PractitionerWATBD

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.

Verify on CMS Revalidation Lookup Tool

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 98632)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991696395View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Family PracticeWA
Nurse PractitionerWA
-WA
Nurse PractitionerOR
Family PracticeWA

Reviews

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Frequently asked questions

Where can patients find BETHANY L MADDEN (ARNP)'s NPI?
You can confirm BETHANY L MADDEN (ARNP) with NPI 1104691658; it appears in the national provider directory.
Does this profile mean BETHANY L MADDEN (ARNP) is currently active?
Yes — BETHANY L MADDEN (ARNP) appears active in the national provider directory.
Does BETHANY L MADDEN (ARNP) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for BETHANY L MADDEN (ARNP). Clinical services aligned with this taxonomy classification.
What location shows for BETHANY L MADDEN (ARNP)?
We surface Longview, Washington for BETHANY L MADDEN (ARNP) based on available NPPES addresses.
What if Longview, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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