Active NPI
Marydina Kirkby, RN
- Registered Nurse
- Bellevue, WA
National Provider Identifier
1255377883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN00116530
- Practice address
- 16126 NE 3Rd PL
Bellevue, WA 98008-4433 - Phone
- (425) 417-7477
- NPI assigned
- Jun 21, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00116530 | WA | Primary |
| Nurse Practitioner | 363L00000X | AP30005811 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP30005811 | WA |
Addresses
Primary practice location
16126 NE 3Rd PL
Bellevue, WA 98008-4433
Mailing address
15600 NE 8TH St. B1#216
Bellevue, WA 98008-3927
Phone (425) 417-7477
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16088U | Other | WA | REGENCE BLUE SHIELD PIN |
| 9633983 | Medicaid | WA | |
| 0161864 | Other | WA | L&I PIN |
Other names 1
- Marydina Salmasizadhe
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)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00116530 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461024000000",
"number": "1255377883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15600 NE 8TH ST. B1#216",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980083927",
"telephone_number": "425-417-7477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16126 NE 3RD PL",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980084433",
"telephone_number": "425-417-7477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKBY",
"first_name": "MARYDINA",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-21",
"last_updated": "2016-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00116530",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30005811",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30005811",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD PIN",
"identifier": "16088U",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9633983",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I PIN",
"identifier": "0161864",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARYDINA",
"last_name": "SALMASIZADHE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.