Individual provider Active NPI

Jeffrey Karl Kiki, D.O.

  • Family Medicine Physician
  • West Richland, WA
National Provider Identifier
1003874017
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP 60120424 Issued in WA
Practice address
3950 Keene Rd
West Richland, WA 99353
Phone
(509) 942-3627
Fax
(509) 628-8335
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP 60120424 WA Primary

Addresses

Primary practice location

3950 Keene Rd
West Richland, WA 99353

Mailing address

3950 Keene Rd
West Richland, WA 99353-4901
Phone (509) 942-3130

Other identifiers 1

IdentifierTypeStateIssuer
0261765OtherWALABOR & INDUSTRIES

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkiki1107550@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3950 Keene Rd
West Richland, WA 99353-4901

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP 60120424WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

780 Swift Blvd
Ste 130
Richland, WA 99352
Phone (509) 942-3244

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

945 Goethals Dr
Ste 200
Richland, WA 99352
Phone (509) 942-2555

3950 Keene Rd
West Richland, WA 99353
Phone (509) 942-3130

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1003874017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 KEENE RD",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993534901",
            "telephone_number": "509-942-3130",
            "fax_number": "509-628-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 KEENE RD",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "99353",
            "telephone_number": "509-942-3627",
            "fax_number": "509-628-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIKI",
        "first_name": "JEFFREY",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP 60120424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0261765",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkiki1107550@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3950 Keene Rd",
            "city": "West Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "99353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Richland, WA

Sources for this page

Verify at the official NPI Registry.