NPIMap

Individual provider Active NPI

Lindsay Petty, ARNP

  • Family Nurse Practitioner
  • Monroe, WA
National Provider Identifier
1255749776
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60485705 Issued in WA
Practice address
19200 N Kelsey St
Monroe, WA 98272-1431
Phone
(360) 794-7994
NPI assigned
Jul 28, 2014
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60485705 WA Primary

Addresses

Primary practice location

19200 N Kelsey St
Monroe, WA 98272-1431

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other names 1

  • Lindsay McKenzie Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmckenzie463298@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140911000461 WA Practitioner - Nurse Practitioner 3274752977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11911 NE 132ND St
Suite 200
Kirkland, WA 98034-2900
Phone (425) 899-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP60485705WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Sep 1, 2014 Accepting new patients
Providence Health & Services - Washington CurrentSince Sep 1, 2014 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Aug 7, 2019 Accepting new patients
King County Public Hospital District No 2 CurrentSince Aug 7, 2019 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

11911 NE 132nd St
Ste 200
Kirkland, WA 98034
Phone (425) 899-5800

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

19200 N Kelsey St
Monroe, WA 98272
Phone (360) 794-5555

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: lmckenzie463298@wm.providencedirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1255749776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19200 N KELSEY ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721431",
            "telephone_number": "360-794-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "LINDSAY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60485705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmckenzie463298@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19200 N Kelsey St",
            "city": "Monroe",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982721431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "MCKENZIE",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monroe, WA

Sources for this page

Verify at the official NPI Registry.