Kelly Ann Lagervall, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61584219 Issued in WA

Practice address

539 US Highway 12
Chehalis, WA 98532-8404

Phone

(253) 350-5339

NPI assigned

Jul 24, 2024

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heritage Family MedicineGroup PAC ID 8628084712, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Heritage Family Medicine

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1427136977
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1033947643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 US HIGHWAY 12",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328404",
            "telephone_number": "253-350-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 US HIGHWAY 12",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328404",
            "telephone_number": "253-350-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGERVALL",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61584219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• L G Steck Memorial Clinic P S
• L-Cam Corporation
• Laboratory Corporation of America
• Laboratory Corporation of America
• DJ Drake James Lager, SUDP
• Rein H Lambrecht, MD
• Natasha Debra Lynn Lance
• Sarah Frances Landrum, M.D.
• Sierra A Landsidel, CNA
• Jami Larson, LICSW

• Family Nurse Practitioner in Chehalis, WA
• Providers in Chehalis, 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 Jul 24, 2024; 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.