Kenneth J Egli, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

MD00041379 Issued in WA

Practice address

8508 W Gage Blvd Ste A101
Kennewick, WA 99336-8106

Phone

(877) 522-1275

Fax

(833) 888-7145

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Kennewick Emergency Physicians, P.S.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kennewick, WA
  • NPI 1629110564
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1205922879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 DUNBARTON AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018216",
            "telephone_number": "509-222-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8508 W GAGE BLVD STE A101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368106",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523514",
            "country_code": "US",
            "telephone_number": "509-942-2159",
            "fax_number": "509-942-2757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGLI",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00041379",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD00041379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8358749",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0227845",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INS #",
            "identifier": "911348529",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Christine Edler, RN
• Jeanie Edwards, LMP
• Ryan A Edwards, MA, CCC-SLP
• Jason Matthew Egan
• Sheilla Eggimann
• Nicole Eikeness
• Toomas Eisler, MD
• Beth Eldhardt, M.ED
• William L Eldred, SUDPT
• Eli Kaczynski MD PS

• Addiction Medicine (Preventive Medicine) Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Addiction Medicine (Preventive Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.