Active NPI
Indigo Kimmel, BT
- Behavior Technician
- Issaquah, WA
National Provider Identifier
1598428765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1375 NW Mall St Ste 4
Issaquah, WA 98027-8950 - Phone
- (425) 654-0800
- NPI assigned
- Oct 14, 2021
- Last updated
- Oct 14, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1375 NW Mall St Ste 4
Issaquah, WA 98027-8950
Mailing address
700 Front St S Unit C108
Issaquah, WA 98027-4233
Phone (206) 259-1157
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
- Credentials
- Bachelor of Theology
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orchid Health Group, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634169600000",
"number": "1598428765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 FRONT ST S UNIT C108",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980274233",
"telephone_number": "206-259-1157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 NW MALL ST STE 4",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278950",
"telephone_number": "425-654-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMEL",
"first_name": "INDIGO",
"credential": "BT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-14",
"last_updated": "2021-10-14",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.