Kevin T Washington, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4288 Issued in AZ

Practice address

1930 E Thomas Rd
Phoenix, AZ 85016-7711

Phone

(480) 296-6549

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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 and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1043242563
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Ingenuity Medical Group LLC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1417986118
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1306864558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6825 S 35TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416121",
            "telephone_number": "602-618-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167711",
            "telephone_number": "480-296-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "KEVIN",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "4288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashante Washington
• Carmen Rozelle Washington, EDD, FNP
• Charee E Washington, LCSW
• Deandrea Washington, PMHNP-BC
• Jaliah Danae Washington
• Keyonna Lynnette Washington
• Selena Washington
• Sharnette Washington, FNP-C
• Shima Washington, FNP-C, PMHNP-BC
• Shonta Washington, RN

• Emergency Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.