Active NPI
Linda Sue Kellams, NURSE PRACTITIONER
- Nurse Practitioner
- Olympia, WA
National Provider Identifier
1205980828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30004049
- Practice address
- 2114 Caton Way SW # 201
Olympia, WA 98502-1105 - Phone
- (360) 709-3332
- Fax
- (360) 709-3336
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30004049 | WA | Primary |
Addresses
Primary practice location
2114 Caton Way SW # 201
Olympia, WA 98502-1105
Mailing address
2114 Caton Way SW # 201
Olympia, WA 98502-1105
Phone (360) 709-3332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2022 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric and Counseling Services of Olympia, PS | Past | Accepting new patients | |
| The Evergreen Clinic | Past | Accepting new patients |
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Olympia, WA
- NPI 1013123629
-
- Psychiatry Physician
- Kirkland, WA
- NPI 1447314539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273622400000",
"number": "1205980828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2114 CATON WAY SW # 201",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985021105",
"telephone_number": "360-709-3332",
"fax_number": "360-709-3336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2114 CATON WAY SW # 201",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985021105",
"telephone_number": "360-709-3332",
"fax_number": "360-709-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLAMS",
"first_name": "LINDA",
"middle_name": "SUE",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2010-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30004049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.