Individual provider Active NPI

Kerbie Salvador A Barrantes, ARNP

  • Family Nurse Practitioner
  • Lakewood, WA
National Provider Identifier
1649800426
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61026274 Issued in WA
Practice address
11318 Bridgeport Way SW
Ste a
Lakewood, WA 98499-3054
Phone
(253) 533-3838
NPI assigned
Jan 22, 2020
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61026274 WA Primary

Addresses

Primary practice location

11318 Bridgeport Way SW
Ste a
Lakewood, WA 98499-3054

Mailing address

3615 Walthew Dr SE
Lacey, WA 98503-4156
Phone (646) 671-9790

Other practice location 1

1006 N H St
Aberdeen, WA 98520-2521
Phone (360) 537-6332

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
I20200423001446 WA Practitioner - Nurse Practitioner 7517397052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grays Harbor Community HospitalGroup PAC ID 3577462365, 91 clinicians

Practice addresses (Care Compare)

11318 Bridgeport Way SW
Suite a
Lakewood, WA 98499-3054
Phone (253) 533-3838

319 E Pioneer Ave
Montesano, WA 98563-4601
Phone (360) 249-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61026274WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Keybridge Health Supplies LLC Current Accepting new patients
Grays Harbor Community Hospital CurrentSince May 1, 2020 Accepting new patients
Grays Harbor Community Hospital Current Accepting new patients
Grays Harbor Community Hospital CurrentSince May 1, 2020 Accepting new patients
Key Bridge Medical Clinic LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

1006 N H St
Aberdeen, WA 98520
Phone (360) 537-6032

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

11318 Bridgeport Way SW
Ste A
Lakewood, WA 98499
Phone (253) 380-8905

319 E Pioneer Ave
Montesano, WA 98563
Phone (360) 249-1980

Organizations & group practices 5

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 3

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": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1649800426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 WALTHEW DR SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985034156",
            "telephone_number": "646-671-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11318 BRIDGEPORT WAY SW",
            "address_2": "STE A",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993054",
            "telephone_number": "253-533-3838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1006 N H St",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "985202521",
            "country_code": "US",
            "telephone_number": "360-537-6332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRANTES",
        "first_name": "KERBIE SALVADOR",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61026274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.