Kelsey Wardlow

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60887650 Issued in WA

Practice address

134 188TH St S
Spanaway, WA 98387-4618

Phone

(253) 847-2304

NPI assigned

Aug 30, 2018

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health CareGroup PAC ID 1850201559, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
• Direct secure messaging: kelsey.wardlowpac.p1@direct.chc-tacoma.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Tacoma, WA
  • NPI 1790762755
  Medicare reassignment Care Compare group NPD
• Community Health Care

  dba Puyallup

  • Federally Qualified Health Center (FQHC)
  • Puyallup, WA
  • NPI 1003515594
  NPD

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1760964316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 188TH ST S",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874618",
            "telephone_number": "253-847-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 188TH ST S",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874618",
            "telephone_number": "253-847-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDLOW",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60887650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores, Inc (Vision Center 30-3218)
• Walmart Inc. (Walmart Pharmacy 10-3218)
• Hallie Rose Lim Walsh
• Dongxia Wang
• Edward J Wang, DMD
• Ryan Alexis Ware
• Warm Touch Afh
• Kathryn Washburn, RN
• Jordan Watson, RD
• Patricia Weber, OTR/L

• Physician Assistant in Spanaway, WA
• Providers in Spanaway, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.