Kimberlee Elizabeth Poole

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30006565 Issued in WA

Practice address

1550 S Pioneer Way Ste 200
Moses Lake, WA 98837-4614

Phone

(509) 793-9787

Fax

(509) 764-3263

NPI assigned

Jun 23, 2005

Last updated

May 4, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Grant County Public Hospital District 1

  dba Samaritan Clinic

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment NPD
• Grant County Public Hospital District 1

  dba Samaritan Clinic on Patton

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1609112739
  NPD
• Grant County Public Hospital District 1

  dba Samaritan

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  NPD
• Grant County Public Hospital District 1

  dba Samaritan Hospitalist Group

  • Hospitalist Physician
  • Moses Lake, WA
  • NPI 1053981910
  NPD (past)
• Integra Imaging, PS

  • Diagnostic Radiology Physician
  • Spokane, WA
  • NPI 1205189461
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1275539256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S PIONEER WAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372487",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S PIONEER WAY STE 200",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374614",
            "telephone_number": "509-793-9787",
            "fax_number": "509-764-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "KIMBERLEE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0235658",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I POST 7/21/13",
            "identifier": "314892",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01256552",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275539256",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpoole1203498@wm.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "EPIC EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1550 S Pioneer Way Ste 200",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988374614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ambar Pineda
• Judy Ann Pippins, LMT, LMT, NCTMB
• Planned Parenthood of Greater Washington and North Idaho (Ppgwni)
• Podium Physical Therapy & Performance Training PLLC
• Donna Ivette Ponce
• Micajah R. Poole
• Rylee Powell
• McClayne Thomas Powers
• Elizabeth Pray
• Premier Health Womens Wellness and Obstetrics (Premier Health)

• Nurse Practitioner in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.