Individual provider Active NPI

Katherine Teresa Kehoe, ARNP

  • Pediatric Nurse Practitioner
  • Centralia, WA
National Provider Identifier
1851649198
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
N360303146 Issued in WA
Practice address
1911 Cooks Hill Rd
Centralia, WA 98531-9073
Phone
(360) 736-6778
Fax
(360) 736-6552
NPI assigned
Aug 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X N360303146 WA Primary

Addresses

Primary practice location

1911 Cooks Hill Rd
Centralia, WA 98531-9073

Mailing address

1911 Cooks Hill Rd
Centralia, WA 98531-9073
Phone (360) 736-6778

Other identifiers 1

IdentifierTypeStateIssuer
2021571MedicaidWA

Other names 1

  • Katherine Teresa Sheahan Former name

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
I20200729002019 WA Practitioner - Nurse Practitioner 8022394873 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N360303146WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jul 6, 2020 Accepting new patients
Multicare Health System CurrentSince Jul 6, 2020 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

1911 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 736-6552

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: kkehoe@nwpc.opdirect.net
  • Direct secure messaging: kkehoe490008@direct.multicare.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1851649198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHOE",
        "first_name": "KATHERINE",
        "middle_name": "TERESA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "N360303146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021571",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "SHEAHAN",
            "middle_name": "TERESA",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Centralia, WA

Sources for this page

Verify at the official NPI Registry.