NPIMap

Organization Active NPI

MB2K, LLC

Doing business as Familycare of Kent

  • Primary Care Clinic/Center
  • Kent, WA
National Provider Identifier
1821276759
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
AP30001318 Issued in WA
Legal business name
MB2K, LLC
Doing business as
Familycare of Kent
Practice address
10024 SE 240TH St
Suite 201
Kent, WA 98031-5124
Phone
(253) 859-2273
Fax
(253) 850-8894
NPI assigned
Feb 1, 2008
Last updated
Jul 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Authorized official

Name
Madeline D Wiley, ARNPNPI 1932195526
Title
Owner/Manager
Phone
(253) 859-2273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X AP30001318 WA Primary

Addresses

Primary practice location

10024 SE 240TH St
Suite 201
Kent, WA 98031-5124

Mailing address

10024 SE 240TH St
Suite 201
Kent, WA 98031-5124
Phone (253) 859-2273

Other identifiers 1

IdentifierTypeStateIssuer
9626888MedicaidWA

Other names 1

  • FAMILYCARE OF KENT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051227000135 WA Part B Supplier - Clinic/Group Practice 5799707337 Receives reassigned benefits from 12 practitioners
Practice locations: Kent, WA

National Provider Directory

National Provider Directory
Tax ID family
Familycare of Kent2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

  • MB2K, LLC

    dba FamilyCare of Kent

    • Family Nurse Practitioner
    • Kent, WA
    • NPI 1063826329
    NPD tax ID

Locations

10024 SE 240th St
Ste 201
Kent, WA 98031
Phone (253) 859-2273

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1821276759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10024 SE 240TH ST",
            "address_2": "SUITE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980315124",
            "telephone_number": "253-859-2273",
            "fax_number": "253-850-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 SE 240TH ST",
            "address_2": "SUITE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980315124",
            "telephone_number": "253-859-2273",
            "fax_number": "253-850-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MB2K, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "MADELINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "253-859-2273",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "AP30001318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9626888",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILYCARE OF KENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.