Individual provider Active NPI

Emily Lane Kimble, CNP, ARNP

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1043525652
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61105809 Issued in WA
Practice address
4400 37TH Ave S
Seattle, WA 98118-1609
Phone
(206) 461-6957
Fax
(206) 461-7810
NPI assigned
Aug 9, 2010
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.11840-NP OH
Family Nurse Practitioner 363LF0000X 95000144 CA
Family Nurse Practitioner 363LF0000X AP61105809 WA Primary
Registered Nurse 163W00000X RN.349120 OH
Registered Nurse 163W00000X 95021864 CA

Addresses

Primary practice location

4400 37TH Ave S
Seattle, WA 98118-1609

Mailing address

PO Box 3835
Seattle, WA 98124-3835

Other names 1

  • Emily Joy Lane Former name

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
I20210127003498 WA Practitioner - Nurse Practitioner 8628262037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborcare HealthGroup PAC ID 0143134205, 100 clinicians

Practice addresses (Care Compare)

12721 30TH Ave NE
Seattle, WA 98125-4498
Phone (206) 417-0326

4400 37TH Ave S
Seattle, WA 98118-1609
Phone (206) 461-6957

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.349120OHMDRegistered Nurse
COA.11840-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Jan 19, 2021 Accepting new patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Jan 19, 2021 Accepting new patients
Clinica Sierra Vista Past Accepting new patients

Locations

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

Interoperability endpoints

  • Direct secure messaging: ekimble329379@direct.ochin.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1043525652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3835",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 37TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181609",
            "telephone_number": "206-461-6957",
            "fax_number": "206-461-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "EMILY",
        "middle_name": "LANE",
        "name_prefix": "Ms.",
        "credential": "CNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.11840-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000144",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61105809",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.349120",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95021864",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "LANE",
            "middle_name": "JOY",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.