NPIMap

Organization Active NPI

Independent Anesthesiologists of Kitsap Co

  • Anesthesiology Physician
  • Bremerton, WA
National Provider Identifier
1285795815
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
601433588 Issued in WA
Legal business name
INDEPENDENT ANESTHESIOLOGISTS OF KITSAP CO
Practice address
2025 Wheaton Way
Suite 102
Bremerton, WA 98310-4300
Phone
(360) 479-0809
Fax
(360) 377-3577
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Mr. Jeffrey Park Leake, MDNPI 1427119049
Title
President
Phone
(360) 479-0809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 601433588 WA Primary

Addresses

Primary practice location

2025 Wheaton Way
Suite 102
Bremerton, WA 98310-4300

Mailing address

2025 Wheaton Way
Suite 102
Bremerton, WA 98310-4300
Phone (360) 479-0809

Other identifiers 4

IdentifierTypeStateIssuer
038299OtherWALABOR AND INDUSTRIES
013194010OtherWAGROUP HEALTH COOPERATIVE
7077134MedicaidWA
192575000OtherWAOWCP

National Provider Directory

National Provider Directory

Locations

2025 Wheaton Way
Ste 102
Bremerton, WA 98310
Phone (360) 479-0809

2613 Wheaton Way
Bremerton, WA 98310
Phone (360) 479-5908

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1285795815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 WHEATON WAY",
            "address_2": "SUITE 102",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104300",
            "telephone_number": "360-479-0809",
            "fax_number": "360-377-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 WHEATON WAY",
            "address_2": "SUITE 102",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104300",
            "telephone_number": "360-479-0809",
            "fax_number": "360-377-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT ANESTHESIOLOGISTS OF KITSAP CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "LEAKE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "PARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-479-0809",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "601433588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "038299",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH COOPERATIVE",
            "identifier": "013194010",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7077134",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "192575000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.