Individual provider Active NPI

Katherine Elizabeth Reynolds, ARNP

  • Family Nurse Practitioner
  • Spokane Valley, WA
National Provider Identifier
1114585346
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60969823 Issued in WA
Practice address
1212 N Pines Rd
Spokane Valley, WA 99206-4939
Phone
(509) 893-8140
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60969823 WA
Family Nurse Practitioner 363LF0000X AP60969823 WA Primary

Addresses

Primary practice location

1212 N Pines Rd
Spokane Valley, WA 99206-4939

Mailing address

956 E Hartson Ave Apt 2
Spokane, WA 99202-2337
Phone (253) 218-9234

Other identifiers 1

IdentifierTypeStateIssuer
AP60969823OtherWAARNP LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kreynolds1149181@wm.providencedirect.org Direct

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
I20190821001805 WA Practitioner - Nurse Practitioner 3173851722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1212 N Pines Rd
Spokane Valley, WA 99206-4939
Phone (509) 893-8140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60969823WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Sep 16, 2019 Accepting new patients
Providence Health & Services Washington CurrentSince Sep 16, 2019 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

1212 N Pines Rd
Spokane Valley, WA 99206
Phone (509) 474-5445

Interoperability endpoints

  • Direct secure messaging: kreynolds1149181@wm.providencedirect.org

Organizations & group practices 3

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 5

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1114585346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 E HARTSON AVE APT 2",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022337",
            "telephone_number": "253-218-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N PINES RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064939",
            "telephone_number": "509-893-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60969823",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60969823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "AP60969823",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kreynolds1149181@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1212 N Pines Rd",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992064939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.