Individual provider Active NPI

Kathryn George, ARNP

  • Family Nurse Practitioner
  • Edmonds, WA
National Provider Identifier
1801341870
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60676460 Issued in WA
Practice address
21911 76TH Ave W Ste 110
Edmonds, WA 98026-7918
NPI assigned
Aug 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60676460 WA
Family Nurse Practitioner 363LF0000X RN60177789 WA
Family Nurse Practitioner 363LF0000X AP60676460 WA Primary

Addresses

Primary practice location

21911 76TH Ave W Ste 110
Edmonds, WA 98026-7918

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

15418 Main St
Mill Creek, WA 98012-9030
Phone (425) 225-8004

Other practice location 2

15418 Main St
Mill Creek, WA 98012-9030
Phone (425) 225-8004

Other identifiers 1

IdentifierTypeStateIssuer
2066621MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgeorge1041706@wm.providencedirect.org Direct

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
I20161006001885 WA Practitioner - Nurse Practitioner 1951699966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

21911 76TH Ave W
Suite 110
Edmonds, WA 98026-7918
Phone (425) 640-4950

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60676460WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Sep 19, 2016 Accepting new patients
Swedish Health Services CurrentSince Oct 1, 2017 Accepting new patients
Optum Care Washington PLLC CurrentSince Sep 19, 2016 Accepting new patients
Swedish Health Services CurrentSince Oct 1, 2017 Accepting new patients

Locations

21911 76th Ave W
Ste 110
Edmonds, WA 98026
Phone (425) 640-4950

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

15418 Main St
Mill Creek, WA 98012
Phone (425) 225-8000

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

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 2

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": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1801341870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W STE 110",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15418 Main St",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980129030",
            "country_code": "US",
            "telephone_number": "425-225-8004",
            "fax_number": "425-225-8021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15418 Main St",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980129030",
            "country_code": "US",
            "telephone_number": "425-225-8004",
            "fax_number": "425-225-8021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KATHRYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60676460",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "RN60177789",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60676460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2066621",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgeorge1041706@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21911 76th Ave W Ste 110",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980267918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.