Active NPI
Kelsey Gullickson
- Nurse Practitioner
- Seattle, WA
National Provider Identifier
1467911800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP60904899
- Practice address
- 550 17TH Ave Ste 540
Seattle, WA 98122-4470 - Phone
- (206) 386-3880
- Fax
- (206) 386-3882
- NPI assigned
- Mar 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | AP60904899 | WA | |
| Nurse Practitioner | 363L00000X | AP60904899 | WA | Primary |
Addresses
Primary practice location
550 17TH Ave Ste 540
Seattle, WA 98122-4470
Mailing address
PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2141571 | Medicaid | WA | |
| AP60904899 | Other | WA | WASHINGTON STATE NURSE PRACTITIONER LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Select Outpatient Services Inc
Practice addresses (Care Compare)
2600 Compass Rd
Glenview, IL 60026-8001
550 17TH Ave
Suite 540
Seattle, WA 98122-4470
Phone (206) 386-3880
Hospital & facility affiliations
- Providence at Home With Compassus Home Health, King
- Assured Home Health
- Swedish Medical Center / Cherry Hill
- Olympic Medical Center
- Evergreenhealth Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.1 of 100
- Quality
- 84.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.46
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60904899 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Health Services | Current | Accepting new patients | |
| Swedish Health Services | Past | Accepting new patients |
Locations
7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800
747 Broadway
Seattle, WA 98122
Phone (360) 658-2488
550 17th Ave
Ste 540
Seattle, WA 98122
Phone (206) 386-3880
Interoperability endpoints
- kgullickson3208962@wm.providencedirect.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1689612954
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
-
- Surgery Physician
- Seattle, WA
- NPI 1053368571
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Angeles, WA
- NPI 1306845557
-
- Home Health Agency
- Tukwila, WA
- NPI 1972325983
-
- General Acute Care Hospital
- Kirkland, WA
- NPI 1033174933
-
- Home Health Agency
- Mountlake Terrace, WA
- NPI 1770998528
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1356496582
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733529600000",
"number": "1467911800",
"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": "550 17TH AVE STE 540",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981224470",
"telephone_number": "206-386-3880",
"fax_number": "206-386-3882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLICKSON",
"first_name": "KELSEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-15",
"last_updated": "2024-12-07",
"certification_date": "2024-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WA",
"license": "AP60904899",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP60904899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2141571",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE NURSE PRACTITIONER LICENSE",
"identifier": "AP60904899",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.