Kelly Christine Glidewell, ARNP STUDENT

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60766260 Issued in WA

Practice address

1200 E Columbia Ave
Colville, WA 99114-3354

Phone

(509) 684-3701

Fax

(509) 684-5817

NPI assigned

May 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Colville Medical Center PSGroup PAC ID 6709774086, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Home health agency, Spokane Valley, WA, CCN 507044
• Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326
• Providence St Joseph Hospital Hospital, Chewelah, WA, CCN 501309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Providence Health & Services Washington

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Washington Home Health, Inc.

  • Home Health Agency
  • Spokane Valley, WA
  • NPI 1336379015
  Care Compare affiliation
• Providence Health & Services - Wa

  • Critical Access Hospital
  • Chewelah, WA
  • NPI 1750532321
  Care Compare affiliation
• Providence Health & Services - Washington

  • Critical Access Hospital
  • Colville, WA
  • NPI 1003067679
  Care Compare affiliation

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1821444704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E COLUMBIA AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991143354",
            "telephone_number": "509-684-3701",
            "fax_number": "509-684-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDEWELL",
        "first_name": "KELLY",
        "middle_name": "CHRISTINE",
        "credential": "ARNP STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60766260",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60766260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kglidewell604453@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 E Columbia Ave",
            "city": "Colville",
            "state": "WA",
            "country_code": "US",
            "postal_code": "991143354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cherie M Gilbert, RN
• Maranda S Gillespie
• Emilee Brooke Gisler
• Kayla A Gleave
• Joel A Glidewell, ARNP
• Lisa Lynn Golden
• Georgia Rae Goot, A.A.S.
• Yvette Goot
• Paula M Gormon, CDP
• Ronald Graham

• Nurse Practitioner in Colville, WA
• Providers in Colville, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.