Kimberly Ruth Poppe, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30005862 Issued in WA

Practice address

916 Pacific Ave
First Floor
Everett, WA 98201-4147

Phone

(425) 258-7390

Fax

(425) 258-7379

NPI assigned

Sep 29, 2006

Last updated

Apr 5, 2012By the provider in NPPES

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

Other identifiers 1

Other names 1

• Kimberly Ruth Hudson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• In Home Primary Care, PLLC

  • Gerontology Nurse Practitioner
  • Snohomish, WA
  • NPI 1356469720
  NPD (past)
• Northwest Hospital & Medical Center

  dba Meridian Women's Health

  • Obstetrics & Gynecology Physician
  • Seattle, WA
  • NPI 1730355199
  NPD (past)
• Northwest Hospital Provider Trust

  dba Kent Sullivan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Seattle, WA
  • NPI 1770545352
  NPD (past)
• Cfsatc Inc

  dba Central Florida Treatment Centers

  • Community/Behavioral Health Agency
  • Titusville, FL
  • NPI 1780329359
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1073605671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N BROADWAY",
            "address_2": "PBO",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011409",
            "telephone_number": "425-317-0699",
            "fax_number": "425-317-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 PACIFIC AVE",
            "address_2": "FIRST FLOOR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014147",
            "telephone_number": "425-258-7390",
            "fax_number": "425-258-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPE",
        "first_name": "KIMBERLY",
        "middle_name": "RUTH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30005862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9631375",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HUDSON",
            "middle_name": "RUTH",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mark Christian Poole
• Marsha Kimberley Poole, PHARMD
• Perry Yui Ming Poon, RPH
• Ksenia Popova
• Mariya Petrovna Popova, SUDP/T
• Leslie Dean Poppe, PHD
• Amalia D Poquiz, OD
• Port Gardner Bay Recovery
• Jennifer Porter, LPN
• Melinda Ann Porter

• Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.