Individual provider Active NPI

Kathy J Wilmering, MSW ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1083758924
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30002439 Issued in WA
Practice address
1915 25TH Ave S Unit a
Seattle, WA 98144-4705
Phone
(206) 632-9522
Fax
(206) 632-9522
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30002439 WA Primary
Social Worker 104100000X LH00006554 WA
Counselor 101Y00000X LH00006554 WA

Addresses

Primary practice location

1915 25TH Ave S Unit a
Seattle, WA 98144-4705

Mailing address

4412 California Ave SW Unit 16325
Seattle, WA 98116-0816
Phone (206) 632-9522

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
I20051221000153 WA Practitioner - Nurse Practitioner 1456373232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1915 25TH Ave S
Unit a
Seattle, WA 98144-4705
Phone (206) 632-9522

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LH00006554WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seachange Health & Wellness Inc Counselor CurrentSince May 6, 1994 Accepting new patients

Locations

1900 N Northlake Way
Ste 127
Seattle, WA 98103
Phone (206) 632-9522

4412 California Ave SW
Unit 16325
Seattle, WA 98116

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1083758924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 CALIFORNIA AVE SW UNIT 16325",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981160816",
            "telephone_number": "206-632-9522",
            "fax_number": "206-632-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 25TH AVE S UNIT A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444705",
            "telephone_number": "206-632-9522",
            "fax_number": "206-632-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMERING",
        "first_name": "KATHY",
        "middle_name": "J",
        "credential": "MSW ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30002439",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LH00006554",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH00006554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.