Active NPI
Christopher A Kodama, MD
- Pediatrics Physician
- Mercer Island, WA
National Provider Identifier
1659466605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00042417
- Practice address
- 8211 SE 36TH St
Mercer Island, WA 98040-3030 - Phone
- (206) 240-3741
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00042417 | WA | Primary |
Addresses
Primary practice location
8211 SE 36TH St
Mercer Island, WA 98040-3030
Mailing address
8211 SE 36TH St
Mercer Island, WA 98040-3030
Phone (206) 240-3741
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00042417 | WA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733270400000",
"number": "1659466605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8211 SE 36TH ST",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980403030",
"telephone_number": "206-240-3741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8211 SE 36TH ST",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980403030",
"telephone_number": "206-240-3741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODAMA",
"first_name": "CHRISTOPHER",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2024-12-04",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00042417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.