Active NPI
Kelly M Weston, OI
- Specialist
- Kent, WA
National Provider Identifier
1851611230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OI 60157011
- Practice address
- 10811 SE Kent Kangley Rd
Kent, WA 98030-7108 - Phone
- (253) 854-5660
- Fax
- (253) 893-7413
- NPI assigned
- Jun 8, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OI 60157011 | WA | Primary |
Addresses
Primary practice location
10811 SE Kent Kangley Rd
Kent, WA 98030-7108
Mailing address
10811 SE Kent Kangley Rd
Kent, WA 98030-7108
Phone (253) 854-5660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7018518 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OI 60157011 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1851611230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10811 SE KENT KANGLEY RD",
"city": "KENT",
"state": "WA",
"postal_code": "980307108",
"telephone_number": "253-854-5660",
"fax_number": "253-893-7413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10811 SE KENT KANGLEY RD",
"city": "KENT",
"state": "WA",
"postal_code": "980307108",
"telephone_number": "253-854-5660",
"fax_number": "253-893-7413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTON",
"first_name": "KELLY",
"middle_name": "M",
"credential": "OI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-08",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "OI 60157011",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7018518",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}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 Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.