Individual provider Active NPI

Kevin Michael Trippe, ARNP

  • Gerontology Nurse Practitioner
  • Burien, WA
National Provider Identifier
1033721667
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP61072776 Issued in WA
Practice address
16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone
(253) 426-6341
Fax
(253) 426-6344
NPI assigned
Aug 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61072776 WA
Gerontology Nurse Practitioner 363LG0600X AP61072776 WA Primary

Addresses

Primary practice location

16251 Sylvester Rd SW
Burien, WA 98166-3017

Mailing address

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (253) 426-6341

Other identifiers 1

IdentifierTypeStateIssuer
2165346MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktrippe646122@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201124002721 WA Practitioner - Nurse Practitioner 6608287552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9801 Frontier Ave SE
Snoqualmie, WA 98065-5200
Phone (425) 831-2313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61072776WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 4 King County Washington CurrentSince Jul 1, 2022 Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Jul 1, 2022 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients

Locations

9801 Frontier Ave SE
Snoqualmie, WA 98065
Phone (425) 831-2300

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1033721667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16251 SYLVESTER RD SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663017",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16251 SYLVESTER RD SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663017",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPPE",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61072776",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61072776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165346",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktrippe646122@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16251 Sylvester Rd SW",
            "city": "Burien",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981663017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.