Kayla R Shull, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61217782 Issued in WA

Practice address

505 Washington Ave S
Kent, WA 98032-5709

Phone

(253) 833-7444

Fax

(253) 661-8644

NPI assigned

Mar 11, 2019

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 identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Valley Cities Counseling and ConsultationGroup PAC ID 6406842053, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Valley Cities Counseling and Consultation

  • Community/Behavioral Health Agency
  • Kent, WA
  • NPI 1972668853

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  Medicare reassignment Care Compare group
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1578593562

  Single Specialty

  Medicare reassignment NPD
• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment
• Neighborcare Health

  dba Neighborcare Health at Lincoln High School

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275187429
  NPD
• Overlake Medical Clinics LLC

  • Specialist
  • Bellevue, WA
  • NPI 1871745703
  NPD

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1538627468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 NAGLE PL APT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222447",
            "telephone_number": "808-840-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WASHINGTON AVE S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325709",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 18th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981444317",
            "country_code": "US",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULL",
        "first_name": "KAYLA",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "60866729",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61217782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "602405676",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shining Home Healthcare Services LLC
• Maryan Shire, RN
• Joshua Shotkoski
• Edith Shreckengast, RDN
• Faizah Edris Shukru, LSWAIC
• Emily H M Shultz, MS, CCC-SLP
• Kathryn Shultz, M.S.-SLP
• Avani Sidhu
• Sam Allen Sievertsen
• Gregory Sigrist, CAAC/MHP

• Psychiatric/Mental Health Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.