Mary Louise McKevitt, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30004306 Issued in WA

Practice address

4361 Talbot Rd S
Renton, WA 98055-6226

Phone

(425) 255-5111

Fax

(425) 254-0985

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Louise Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Associated Valley Providers PLLC

  • Family Medicine Physician
  • Renton, WA
  • NPI 1043490543

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1447319330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 TALBOT ROAD SOUTH",
            "address_2": "SUITE #112",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556226",
            "telephone_number": "425-255-5111",
            "fax_number": "425-254-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 TALBOT RD S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556226",
            "telephone_number": "425-255-5111",
            "fax_number": "425-254-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEVITT",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00037524",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30004306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JACKSON",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney McGrue, LICSW
• Sean Gregory McHugh
• Shirhonda Montice McKee, SUDT
• Megan Lynn McKeegan, MA, LMHC, MHP
• Morgan McKenna-Robinson
• Silvia Speidel McKevitt, MD
• Rachel McKnight
• Erin McLaughlin, MD
• Jessica Lyn McLaughlin
• Jessica E McMurdie, OTR/L

• Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.