Kevin Jon Molander, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00046086 Issued in WA

Practice address

55 W Tietan St
Walla Walla, WA 99362-4445

Phone

(509) 525-3720

Fax

(509) 522-1593

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Northwest Healthcare and Wellness Center, PLLC

  • Family Medicine Physician
  • Richland, WA
  • NPI 1194812305
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013975036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624445",
            "telephone_number": "509-525-3720",
            "fax_number": "509-522-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624445",
            "telephone_number": "509-525-3720",
            "fax_number": "509-522-1593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 TORBETT ST",
            "address_purpose": "LOCATION",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542604",
            "country_code": "US",
            "telephone_number": "509-946-7646",
            "fax_number": "509-946-7666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 TORBETT ST",
            "address_purpose": "LOCATION",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542604",
            "country_code": "US",
            "telephone_number": "509-946-7646",
            "fax_number": "509-946-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLANDER",
        "first_name": "KEVIN",
        "middle_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00046086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000443",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01287754",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013975036",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.