Individual provider Active NPI

Kerri W. Scarbrough, OD

  • Optometrist
  • Woodinville, WA
National Provider Identifier
1699760744
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WA1675TX Issued in WA
Practice address
17320 135TH Ave NE Ste D
Woodinville, WA 98072-8565
Phone
(425) 398-1862
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X WA1675TX WA Primary

Addresses

Primary practice location

17320 135TH Ave NE Ste D
Woodinville, WA 98072-8565

Mailing address

17320 135TH Ave NE Ste D
Woodinville, WA 98072-8565
Phone (425) 398-1862

Other identifiers 1

IdentifierTypeStateIssuer
2023877MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
WA1675TXWAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1699760744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17320 135TH AVE NE STE D",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728565",
            "telephone_number": "425-398-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17320 135TH AVE NE STE D",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728565",
            "telephone_number": "425-398-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBROUGH",
        "first_name": "KERRI",
        "middle_name": "W.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "WA1675TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023877",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.