Individual provider Active NPI

Kelly Bastian

  • Registered Nurse
  • Spokane, WA
National Provider Identifier
1386301620
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60630490 Issued in WA
Practice address
4815 N Assembly St
Spokane, WA 99205-6185
Phone
(509) 434-7271
NPI assigned
Nov 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60630490 WA Primary

Addresses

Primary practice location

4815 N Assembly St
Spokane, WA 99205-6185

Mailing address

813 E Westcrest Rd
Colbert, WA 99005-8725
Phone (509) 381-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN60630490WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1386301620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 E WESTCREST RD",
            "city": "COLBERT",
            "state": "WA",
            "postal_code": "990058725",
            "telephone_number": "509-381-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 N ASSEMBLY ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056185",
            "telephone_number": "509-434-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60630490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.