Active NPI
Kristy Ann Lipka, LMP
- Specialist
- Lake Stevens, WA
National Provider Identifier
1497927503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00015572
- Practice address
- 12506 18TH Street NE
Lake Stevens, WA 98258 - Phone
- (425) 334-9664
- NPI assigned
- Mar 28, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00015572 | WA | Primary |
Addresses
Primary practice location
12506 18TH Street NE
Lake Stevens, WA 98258
Mailing address
PO Box 729
Lake Stevens, WA 98258-0729
Phone (425) 334-9664
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00015572 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1497927503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 729",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982580729",
"telephone_number": "425-334-9664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12506 18TH STREET NE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "98258",
"telephone_number": "425-334-9664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPKA",
"first_name": "KRISTY",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00015572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Stevens, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.