Individual provider Active NPI

Katheryn Norris

  • Family Medicine Physician
  • Prosser, WA
National Provider Identifier
1124089875
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00002085 Issued in WA
Practice address
820 Memorial St Ste 1
Prosser, WA 99350-2504
Phone
(509) 786-2010
Fax
(509) 788-1794
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3912 AZ
Family Medicine Physician 207Q00000X OP00002085 WA Primary

Addresses

Primary practice location

820 Memorial St Ste 1
Prosser, WA 99350-2504

Mailing address

820 Memorial St Ste 1
Prosser, WA 99350-2504
Phone (509) 786-2010

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knorris4887@yvfwc.direct-ci.com 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061110000035 WA Practitioner - Family Practice 3274531009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

1000 Wallace Way
Grandview, WA 98930-8805
Phone (509) 882-3444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP00002085WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Jun 1, 2012 Accepting new patients
Yakima Valley Farm Workers Clinic Current Accepting new patients

Locations

1000 Wallace Way
Grandview, WA 98930
Phone (509) 788-1702

713 Memorial St
Prosser, WA 99350
Phone (509) 786-1931

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Interoperability endpoints

  • Direct secure messaging: knorris4887@yvfwc.direct-ci.com

Organizations & group practices 2

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 1

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1124089875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 MEMORIAL ST STE 1",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993502504",
            "telephone_number": "509-786-2010",
            "fax_number": "509-788-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 MEMORIAL ST STE 1",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993502504",
            "telephone_number": "509-786-2010",
            "fax_number": "509-788-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KATHERYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3912",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00002085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knorris4887@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "820 Memorial St Ste 1",
            "city": "Prosser",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993502504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosser, WA

Sources for this page

Verify at the official NPI Registry.