Individual provider Active NPI

Hillary Brooks Allen-Kissick, M.D.

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1851392765
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00042781 Issued in WA
Practice address
510 State Ave NE Ste 101
Olympia, WA 98501-1170
Phone
(833) 411-5469
Fax
(855) 459-3020
NPI assigned
Aug 2, 2005
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00042781 WA Primary

Addresses

Primary practice location

510 State Ave NE Ste 101
Olympia, WA 98501-1170

Mailing address

510 State Ave NE Ste 101
Olympia, WA 98501-1170
Phone (833) 411-5469

Other practice location 1

1217 Cooper Point Rd SW
PMG SW WA W Olympia Fam Med
Olympia, WA 98502-7204
Phone (360) 486-6710

Other practice location 2

403 Black Hills Ln SW Ste B
Olympia, WA 98502-8600
Phone (360) 709-9500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000405 WA Practitioner - Family Practice 0446146088 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00042781WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
600 Stewart Medical Group, P.C. CurrentSince Sep 26, 2022 Accepting new patients
Capital Medical Center Physicians LLC Family Medicine CurrentSince Sep 10, 2018 Accepting new patients
Capital Medical Center Physicians LLC CurrentSince Sep 10, 2018 Accepting new patients
Grays Harbor County Public Hospital District No. 1 Family Medicine Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

403 Black Hills Ln SW
Ste B
Olympia, WA 98502
Phone (360) 709-9500

600 Stewart St
Ste 800
Seattle, WA 98101
Phone (206) 690-5962

2706 W Nob Hill Blvd
Ste 100
Yakima, WA 98902
Phone (206) 848-7500

Interoperability endpoints

  • Direct secure messaging: hillary.allen-kissick.1@2876.direct.athenahealth.com

Organizations & group practices 5

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1851392765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 STATE AVE NE STE 101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011170",
            "telephone_number": "833-411-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 STATE AVE NE STE 101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011170",
            "telephone_number": "833-411-5469",
            "fax_number": "855-459-3020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1217 Cooper Point Rd SW",
            "address_2": "PMG SW WA W Olympia Fam Med",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985027204",
            "country_code": "US",
            "telephone_number": "360-486-6710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 Black Hills Ln SW Ste B",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985028600",
            "country_code": "US",
            "telephone_number": "360-709-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN-KISSICK",
        "first_name": "HILLARY",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.