Individual provider Active NPI

Kerry Elizabeth Fitzpatrick, L.M.P.

  • Specialist
  • Gig Harbor, WA
National Provider Identifier
1811196108
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00012461 Issued in WA
Practice address
1016 29TH St NW
Gig Harbor, WA 98335-1641
Phone
(253) 226-1519
NPI assigned
Jul 16, 2007
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00012461 WA Primary

Addresses

Primary practice location

1016 29TH St NW
Gig Harbor, WA 98335-1641

Mailing address

PO Box 641
Gig Harbor, WA 98335-0641
Phone (253) 226-1519

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00012461WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1811196108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983350641",
            "telephone_number": "253-226-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 29TH ST NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351641",
            "telephone_number": "253-226-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "KERRY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00012461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.