Individual provider Active NPI

Kate Blake, NP

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1073391025
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP70010852 Issued in WA
Practice address
1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone
(801) 587-7000
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X 11782414-3102 UT
Nurse Practitioner 363L00000X 11782414-3102 WA
Nurse Practitioner 363L00000X AP70010852 WA Primary

Addresses

Primary practice location

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500

Mailing address

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500

Other practice location 1

1990 Hospital Dr Ste 100
Sedro Woolley, WA 98284-9315
Phone (360) 856-8800

Other practice location 2

2901 Squalicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 752-5216

Other practice location 3

4545 Cordata Pkwy Ste 1B
Bellingham, WA 98226-7264
Phone (360) 752-5216

Other practice location 4

2000 Hospital Dr
Sedro Woolley, WA 98284-4327
Phone (360) 856-7581

Other practice location 5

1117 Spring St
Friday Harbor, WA 98250-9782
Phone (360) 378-1738

Other names 1

  • Kate Green 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
I20250923000313 WA Practitioner - Nurse Practitioner 6305341355 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

4545 Cordata Pkwy
Suite 1B
Bellingham, WA 98226-7264
Phone (360) 738-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11782414-3102WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Sep 20, 2025 Accepting new patients
Peacehealth CurrentSince Sep 20, 2025 Accepting new patients
Peacehealth CurrentSince Sep 20, 2025 Accepting new patients
Peacehealth Current Accepting new patients
Peacehealth CurrentSince Sep 22, 2025 Accepting new patients
Peacehealth Current Accepting new patients
Peacehealth Medical Group - Sedro Woolley CurrentSince Sep 20, 2025 Accepting new patients

Locations

3015 Squalicum Pkwy
Ste 200
Bellingham, WA 98225
Phone (360) 733-2092

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

4545 Cordata Pkwy
Ste 1B
Bellingham, WA 98226
Phone (360) 752-5216

835 E Fairhaven Ave
Burlington, WA 98233
Phone (360) 755-0641

1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738

1990 Hospital Dr
Ste 100
Sedro Woolley, WA 98284
Phone (360) 856-4141

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: kblake777362@direct.peacehealth.org

Organizations & group practices 7

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 3

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": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1073391025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-587-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Hospital Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sedro Woolley",
            "state": "WA",
            "postal_code": "982849315",
            "country_code": "US",
            "telephone_number": "360-856-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2901 Squalicum Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982251851",
            "country_code": "US",
            "telephone_number": "360-752-5216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4545 Cordata Pkwy Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982267264",
            "country_code": "US",
            "telephone_number": "360-752-5216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Sedro Woolley",
            "state": "WA",
            "postal_code": "982844327",
            "country_code": "US",
            "telephone_number": "360-856-7581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1117 Spring St",
            "address_purpose": "LOCATION",
            "city": "Friday Harbor",
            "state": "WA",
            "postal_code": "982509782",
            "country_code": "US",
            "telephone_number": "360-378-1738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "UT",
            "license": "11782414-3102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "11782414-3102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP70010852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "GREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.