Individual provider Active NPI

Bobbie V. Kumar, MD

  • Family Medicine Physician
  • Shoreline, WA
National Provider Identifier
1275789190
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60605463 Issued in WA
Practice address
604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone
(206) 533-2900
Fax
(206) 533-2901
NPI assigned
Aug 12, 2008
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 068197 GA
Family Medicine Physician 207Q00000X MD60605463 WA Primary

Addresses

Primary practice location

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

550 17th Ave Ste 500
Seattle, WA 98122-5789
Phone (206) 320-4664

Other identifiers 7

IdentifierTypeStateIssuer
003125751CMedicaidGA
003125751BMedicaidGA
P01080856OtherGARAILROAD MEDICARE
003125751AMedicaidGA
GA1349MedicaidSC
003125751FMedicaidGA
003125751DMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkumar1042212@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA, TX, MN, KS5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20120815000642 GA Practitioner - Family Practice 3678729100 Reassigns benefits to 1 organization
I20160204002135 WA Practitioner - Family Practice 3678729100 Reassigns benefits to 1 organization
I20190814001690 TX Practitioner - Family Practice 3678729100 Reassigns benefits to 5 organizations
I20220808000712 MN Practitioner - Family Practice 3678729100
I20230517000650 KS Practitioner - Emergency Medicine 3678729100

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Urgent Care - Flower Mound PLLCGroup PAC ID 0547616625, 14 clinicians

Practice addresses (Care Compare)

2400 Long Prairie Rd
Flower Mound, TX 75022-4800
Phone (940) 222-5215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
068197GAMDFamily Medicine Physician
MD60605463WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine Current Accepting new patients
MPPG, Inc. Family Medicine Current Accepting new patients
Doctors Urgent Care LLC CurrentSince Apr 1, 2022 Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
Conroe Doctors Urgent Care LLC CurrentSince Aug 1, 2019 Accepting new patients
Doctors Urgent Care of Northlake PLLC CurrentSince Mar 15, 2023 Accepting new patients
Doctors Urgent Care - Flower Mound PLLC CurrentSince Oct 1, 2023 Accepting new patients
South Sound Inpatient Physicians, PLLC Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
United Health Centers of the San Joaquin Valley Past Accepting new patients
Memorial Health University Medical Center Inc. Past Accepting new patients
HCA Healthone LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

3780 US Highway 17
Richmond Hill, GA 31324
Phone (912) 756-2292

1107 E 66th St
Savannah, GA 31404
Phone (912) 350-8404

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

17002 Gleneagle Dr S
Conroe, TX 77385
Phone (832) 447-7123

1234 FM 407 W
Ste 200
Northlake, TX 76226
Phone (940) 222-5215

25118 Grogans Mill Rd
The Woodlands, TX 77380
Phone (346) 472-2500

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Interoperability endpoints

  • Direct secure messaging: bkumar1042212@wm.providencedirect.org
  • FHIR API: https://api.platform.athenahealth.com/25054/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1275789190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-533-2900",
            "fax_number": "206-533-2901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 17th Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225789",
            "country_code": "US",
            "telephone_number": "206-320-4664",
            "fax_number": "206-320-8282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "BOBBIE",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "068197",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60605463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125751C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125751B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01080856",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125751A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA1349",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125751F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125751D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkumar1042212@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 17th Ave Ste 500",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981225789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.