NPIMap

Organization Active NPI

Kitsap Gastro and Liver Clinic, PLLC

  • Gastroenterology Physician
  • Poulsbo, WA
National Provider Identifier
1013668524
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
KITSAP GASTRO AND LIVER CLINIC, PLLC
Practice address
22180 Olympic College Way NW Ste 204
Poulsbo, WA 98370-6664
Phone
(360) 447-8951
Fax
(360) 587-2355
NPI assigned
Jan 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Dr. Abimbola Adike, MDNPI 1821357112
Title
Physician Owner
Phone
(360) 447-8951

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X Primary
Hepatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0008X
Transplant Hepatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RT0003X

Addresses

Primary practice location

22180 Olympic College Way NW Ste 204
Poulsbo, WA 98370-6664

Mailing address

22180 Olympic College Way NW Ste 204
Poulsbo, WA 98370-6664
Phone (360) 447-8951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220309002189 WA Part B Supplier - Clinic/Group Practice 4082009006 Receives reassigned benefits from 2 practitioners
Practice locations: Poulsbo, WA

National Provider Directory

National Provider Directory

Locations

22180 Olympic College Way NW
Ste 204
Poulsbo, WA 98370
Phone (360) 447-8951

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1013668524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 204",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-447-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 204",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-447-8951",
            "fax_number": "360-587-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP GASTRO AND LIVER CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "ADIKE",
        "authorized_official_first_name": "ABIMBOLA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "360-447-8951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.