Individual provider Active NPI

Amy E Kyle

  • Licensed Practical Nurse
  • Kelso, WA
National Provider Identifier
1144867516
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
60989878 Issued in WA
Practice address
305 Pacific Ave S Ste C
Kelso, WA 98626-1638
Phone
(360) 795-5008
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 60989878 WA Primary

Addresses

Primary practice location

305 Pacific Ave S Ste C
Kelso, WA 98626-1638

Mailing address

305 Pacific Ave S Ste C
Kelso, WA 98626-1638
Phone (360) 795-5008

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SMART Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60989878WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1144867516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 PACIFIC AVE S STE C",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986261638",
            "telephone_number": "360-795-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 PACIFIC AVE S STE C",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986261638",
            "telephone_number": "360-795-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "AMY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "60989878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SMART",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "305 Pacific Ave S Ste C",
            "city": "Kelso",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986261638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kelso, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.