Individual provider Active NPI

Elizabeth Denali Kerr, M.D.

  • Obstetrics & Gynecology Physician
  • Edmonds, WA
National Provider Identifier
1720326184
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD61002555 Issued in WA
Practice address
21616 76TH Ave W Ste 205
Edmonds, WA 98026-7512
Phone
(425) 640-4810
Fax
(425) 640-4884
NPI assigned
Jan 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD61002555 WA Primary

Addresses

Primary practice location

21616 76TH Ave W Ste 205
Edmonds, WA 98026-7512

Mailing address

209 Martin Luther King Jr Way
Tacoma, WA 98405-4267
Phone (253) 596-3300

Other practice location 1

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Other identifiers 1

IdentifierTypeStateIssuer
1720326184MedicaidWA

Other names 1

  • Denali Kerr Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ekerr1334565@wm.providencedirect.org Direct
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803000481 WA Practitioner - Obstetrics/Gynecology 3173893070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
McMaster Un, Michael Degroote School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61002555WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jun 7, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jun 7, 2022 Accepting new patients
Franciscan Health System Past Accepting new patients

Locations

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

Interoperability endpoints

  • Direct secure messaging: ekerr4075300@ghc.direct-ci.net
  • Direct secure messaging: ekerr1334565@wm.providencedirect.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1720326184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054267",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21616 76TH AVE W STE 205",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267512",
            "telephone_number": "425-640-4810",
            "fax_number": "425-640-4884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054265",
            "country_code": "US",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERR",
        "first_name": "ELIZABETH",
        "middle_name": "DENALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-19",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD61002555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720326184",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekerr1334565@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21616 76th Ave W Ste 205",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980267512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DENALI",
            "last_name": "KERR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.