Individual provider Active NPI

Katherine M Weaver, DDS

  • General Practice Dentistry
  • Kirkland, WA
National Provider Identifier
1619958709
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9147 Issued in WA
Practice address
5726 Lake Washington Blvd NE
Kirkland, WA 98033-7425
Phone
(425) 284-0515
Fax
(425) 284-0516
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9147 WA Primary

Addresses

Primary practice location

5726 Lake Washington Blvd NE
Kirkland, WA 98033-7425

Mailing address

5726 Lake Washington Blvd NE Ste 2
Kirkland, WA 98033-7425
Phone (425) 284-0515

Other identifiers 1

IdentifierTypeStateIssuer
1386001865OtherWANPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251222000533 OR Order and Referring Only - DentistPractitioner - Dentist 7416260518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9147WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine M. McKinney DDS, PS. PastSince Nov 21, 2015 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1619958709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5726 LAKE WASHINGTON BLVD NE STE 2",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337425",
            "telephone_number": "425-284-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 LAKE WASHINGTON BLVD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337425",
            "telephone_number": "425-284-0515",
            "fax_number": "425-284-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1386001865",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.