Kenneth Michael Kingdon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD61498906 Issued in WA

Practice address

PO Box 577
Brewster, WA 98812-0577

Phone

(509) 689-2517

NPI assigned

Feb 7, 2007

Last updated

Mar 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Baylor College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.62 of 100Reported as group

Quality

92.03

Improvement activities

40

Cost

85.07

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkingdon24900@tvc-direct.org

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.

• The Vancouver Clinic Inc PS

  dba The Vancouver Clinic

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Okanogan Douglas County Hospital Dist 1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1205942257
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Medicare reassignment NPD
• Arlington Physician Services PA

  • Obstetrics & Gynecology Physician
  • Mansfield, TX
  • NPI 1093144610

  Surgery

  Medicare reassignment NPD
• Dewitt Medical District

  dba Cuero Regional Hospital

  • Emergency Medicine Physician
  • Cuero, TX
  • NPI 1366532608
  Medicare reassignment NPD
• Frio Hospital Association

  dba Frio Regional Hospital

  • Critical Access Hospital Clinic/Center
  • Pearsall, TX
  • NPI 1952308132

  Emergency Medicine

  Medicare reassignment NPD
• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Georgetown, TX
  • NPI 1922289412
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1578649794

  Emergency Medicine

  NPD
• The Vancouver Clinic Inc PS

  dba Salmon Creek 2 Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
  • NPI 1760004477
  NPD
• Dewitt Medical District

  dba Oakmont Healthcare and Rehabilitation Center of Katy

  • Skilled Nursing Facility
  • Katy, TX
  • NPI 1053511980
  NPD
• Dewitt Medical District

  dba Cuero Medical Clinic

  • Rural Health Clinic/Center
  • Cuero, TX
  • NPI 1730557026

  Family Medicine

  NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1114067196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120577",
            "telephone_number": "509-689-2517",
            "fax_number": "509-689-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120577",
            "telephone_number": "509-689-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGDON",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61498906",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P4471",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P4471",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "P4471",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036126885",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Guadalupe Hurtado Rojas
• Amber Eve Ikeler, DMD
• Shawn Michael Isenhart, DPT
• Larrena Sue Johnson, LMP
• Kimberly Dawn Juarez, LMP
• Janet A Kuester, CRNA
• Kyle M. Gillespie, O.D., LTD. (Gillespie Eye Care)
• L Keith Hanson PLLC
• L R Bryant Medical Corp
• L. Keith Hanson PLLC

• Emergency Medicine Physician in Brewster, WA
• Providers in Brewster, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.