Individual provider Active NPI

Krista Lynn Pursglove, DO

  • Emergency Medicine Physician
  • Olympia, WA
National Provider Identifier
1497246375
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP61286124 Issued in WA
Practice address
3900 Capital Mall Dr SW
Olympia, WA 98502-8654
Phone
(360) 754-5858
NPI assigned
May 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP61286124 WA Primary

Addresses

Primary practice location

3900 Capital Mall Dr SW
Olympia, WA 98502-8654

Mailing address

West 27TH Street
Lumberton, NC 28358
Phone (910) 671-5000

Other practice location 1

14815 Pacific Ave S
Tacoma, WA 98444-4654
Phone (253) 697-8660

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202002565 WA Practitioner - Emergency Medicine 8628328671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olympia Emergency Care Physicians PLLCGroup PAC ID 2769862036, 31 clinicians

Practice addresses (Care Compare)

3900 Capital Mall Dr SW
Olympia, WA 98502-8654
Phone (253) 403-4901

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Emergency Care Physicians PLLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients

Locations

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1497246375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WEST 27TH STREET",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-671-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CAPITAL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-754-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14815 Pacific Ave S",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984444654",
            "country_code": "US",
            "telephone_number": "253-697-8660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURSGLOVE",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61286124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.