Individual provider Active NPI

Kara Elizabeth Kozemzak Smith, FNP-BC

  • Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1639843543
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61195615 Issued in WA
Practice address
5109 Summitview Ave
Yakima, WA 98908-2858
Phone
(509) 907-6300
NPI assigned
Aug 4, 2021
Last updated
Jan 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61195615 WA Primary

Addresses

Primary practice location

5109 Summitview Ave
Yakima, WA 98908-2858

Mailing address

5109 Summitview Ave
Yakima, WA 98908-2858
Phone (509) 907-6300

Other names 1

  • Kara Elizabeth Kozemzak Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksmith35993@yvfwc.direct-ci.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211129001966 WA Practitioner - Nurse Practitioner 6305236738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone (509) 933-8777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61195615WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas County Public Hospital Dist 1 CurrentSince Mar 31, 2024 Accepting new patients
Kittitas County Public Hospital Dist 1 Current Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Mar 31, 2024 Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

700 E Manitoba Ave
Ste 101
Ellensburg, WA 98926
Phone (509) 452-5378

Interoperability endpoints

  • Direct secure messaging: ksmith35993@yvfwc.direct-ci.com

Organizations & group practices 4

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.

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": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1639843543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082858",
            "telephone_number": "509-907-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082858",
            "telephone_number": "509-907-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KARA",
        "middle_name": "ELIZABETH KOZEMZAK",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61195615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith35993@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "5109 Summitview Ave",
            "city": "Yakima",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989082858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARA",
            "last_name": "KOZEMZAK",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.