Individual provider Active NPI

Kendra Manzoni Martinez, ARNP

  • Adult Health Nurse Practitioner
  • Silverdale, WA
National Provider Identifier
1699425504
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP61436670 Issued in WA
Practice address
1780 NW Myhre Rd Ste 1220
Silverdale, WA 98383-8676
Phone
(360) 698-4500
Fax
(360) 698-6960
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61436670 WA
Adult Health Nurse Practitioner 363LA2200X AP61436670 WA Primary

Addresses

Primary practice location

1780 NW Myhre Rd Ste 1220
Silverdale, WA 98383-8676

Mailing address

17408 Hallman Rd NW
Poulsbo, WA 98370-8264
Phone (253) 820-0271

Other identifiers 1

IdentifierTypeStateIssuer
2281232MedicaidWA

Other names 1

  • Kendra Manzoni Crowe Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcrowe285304@fhsce.catholichealth.net Direct Franciscan Medical Group

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
I20240529001830 WA Practitioner - Nurse Practitioner 6406298934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1780 NW Myhre Rd
Suite 1220
Silverdale, WA 98383-8676
Phone (360) 698-4500

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61436670WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 13, 2024 Accepting new patients
Franciscan Medical Group CurrentSince May 13, 2024 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1780 NW Myhre Rd
Ste 1220
Silverdale, WA 98383
Phone (360) 337-6500

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

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 and National Provider Directory roles.

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1699425504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17408 HALLMAN RD NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708264",
            "telephone_number": "253-820-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 NW MYHRE RD STE 1220",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838676",
            "telephone_number": "360-698-4500",
            "fax_number": "360-698-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KENDRA",
        "middle_name": "MANZONI",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61436670",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61436670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2281232",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcrowe285304@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1780 NW Myhre Rd Ste 1220",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983838676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "CROWE",
            "middle_name": "MANZONI",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.