Kortney Kyle Killgore-Smith, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60281165 Issued in WA

Practice address

235 Main Street
Waitsburg, WA 99361

Phone

(509) 337-6311

Fax

(509) 337-6011

NPI assigned

Jun 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Providence Health & Services - Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738
  Medicare reassignment Care Compare group NPD
• Columbia County Hospital District

  • Critical Access Hospital
  • Dayton, WA
  • NPI 1134128911
  Medicare reassignment NPD
• Columbia County Hospital District

  • Rural Health Clinic/Center
  • Dayton, WA
  • NPI 1518044551
  NPD
• Columbia County Hospital District

  • Primary Care Clinic/Center
  • College Place, WA
  • NPI 1851050264
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1023379989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 SOUTH THIRD STREET",
            "city": "DAYTON",
            "state": "WA",
            "postal_code": "99328",
            "telephone_number": "509-382-2531",
            "fax_number": "509-382-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MAIN STREET",
            "city": "WAITSBURG",
            "state": "WA",
            "postal_code": "99361",
            "telephone_number": "509-337-6311",
            "fax_number": "509-337-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLGORE-SMITH",
        "first_name": "KORTNEY",
        "middle_name": "KYLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60281165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Cecilia Abel, MA 60166310
• Barbara Jean Bates
• Columbia County Hospital District
• Columbia Walla Walla Fire District No 2
• Dawn Meicher, ARNP
• Melissa Marie Parra, CEP
• Sanguinity Mobile Medical
• Sanguinity Mobile Medical
• Glenn Arlin Silver, ARNP

• Family Nurse Practitioner in Waitsburg, WA
• Providers in Waitsburg, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.