Individual provider Active NPI

Alexis Marie Kirilovets, LPN

  • Licensed Practical Nurse
  • Olympia, WA
National Provider Identifier
1063164085
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP61217384 Issued in WA
Practice address
3436 Mary Elder Rd NE
Olympia, WA 98506-5050
Phone
(360) 528-2590
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP61217384 WA Primary

Addresses

Primary practice location

3436 Mary Elder Rd NE
Olympia, WA 98506-5050

Mailing address

3436 Mary Elder Rd NE
Olympia, WA 98506-5050
Phone (360) 528-2590

Other names 1

  • Alexis Marie Smith-Cawell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP61217384WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1063164085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 MARY ELDER RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065050",
            "telephone_number": "360-528-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 MARY ELDER RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065050",
            "telephone_number": "360-528-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRILOVETS",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP61217384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "SMITH-CAWELL",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.