Kristopher Kurtis Adams

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

TE61174944 Issued in WA

Practice address

201 NE Park Plaza Dr Ste 145
Vancouver, WA 98684-5873

Phone

(360) 729-8383

Fax

(360) 729-3534

NPI assigned

May 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PeacehealthGroup PAC ID 9739092065, 101 clinicians

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kadams484355@direct.peacehealth.org

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.

• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911
  NPD
• Southwest Washington Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1891785903
  NPD (past)

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1679197370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012682",
            "telephone_number": "503-945-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NE PARK PLAZA DR STE 145",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845873",
            "telephone_number": "360-729-8383",
            "fax_number": "360-729-3534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Center St NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973012682",
            "country_code": "US",
            "telephone_number": "503-945-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "KRISTOPHER",
        "middle_name": "KURTIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "TE61174944",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3247",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "TE61174944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian John Adams, PHD
• Christina P Adams, RDA
• Grace Elizabeth Adams
• Jennifer Lynn Adams, RN
• Katharine Kelly Adams
• Laurie Adams
• Megan Beatrice an Adams
• Nicole L Adams, D.P.M.
• Sharon Adams, BSN, RNC-OB, CDCES
• Zavtra Moya Adams, MSW

• Clinical Psychologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.