Individual provider Active NPI

Katie S. Christensen, NP

  • Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1164450375
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30005734 Issued in WA
Practice address
3010 S Southeast Blvd
Ste a
Spokane, WA 99223-3541
Phone
(509) 688-6700
Fax
(509) 688-6777
NPI assigned
Jun 28, 2006
Last updated
Dec 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X N-29564 ID
Nurse Practitioner 363L00000X NP487A ID
Nurse Practitioner 363L00000X AP30005734 WA Primary

Addresses

Primary practice location

3010 S Southeast Blvd
Ste a
Spokane, WA 99223-3541

Mailing address

PO Box 3867
Spokane, WA 99220-3867
Phone (509) 688-6700

Other identifiers 2

IdentifierTypeStateIssuer
805964500MedicaidID
1003851MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20111104000182 ID Practitioner - Nurse Practitioner 4183897200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP487AIDMDNurse Practitioner
AP30005734WAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1164450375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3867",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203867",
            "telephone_number": "509-688-6700",
            "fax_number": "509-688-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 S SOUTHEAST BLVD",
            "address_2": "STE A",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992233541",
            "telephone_number": "509-688-6700",
            "fax_number": "509-688-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "KATIE",
        "middle_name": "S.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "N-29564",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP487A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30005734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805964500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003851",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.