Individual provider Active NPI

Cynthia Kelley, FNP

  • Family Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1841710779
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60763466 Issued in WA
Practice address
3909 Creekside Loop Ste 130
Yakima, WA 98902-4880
Phone
(509) 574-6095
NPI assigned
Jun 21, 2017
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60763466 WA Primary

Addresses

Primary practice location

3909 Creekside Loop Ste 130
Yakima, WA 98902-4880

Mailing address

3800 Summitview Ave
Yakima, WA 98902-2715
Phone (509) 509-6095

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
I20170824000926 WA Practitioner - Nurse Practitioner 2163794231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kittitas Valley Urgent Care PLLCGroup PAC ID 5092093542, 24 clinicians

Practice addresses (Care Compare)

702 E Mountain View Ave
Suite 1
Ellensburg, WA 98926-3862
Phone (509) 968-5273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas Valley Urgent Care PLLC CurrentSince May 1, 2022 Accepting new patients

Locations

702 E Mountain View Ave
#1
Ellensburg, WA 98926
Phone (509) 968-5273

17 E Valley Mall Blvd
Ste 2B
Union Gap, WA 98903
Phone (509) 367-8733

1006 S 64th Ave
Ste 100
Yakima, WA 98908
Phone (509) 955-9248

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1841710779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022715",
            "telephone_number": "509-509-6095",
            "fax_number": "509-574-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 CREEKSIDE LOOP STE 130",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024880",
            "telephone_number": "509-574-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CYNTHIA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60763466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.