KC Bly, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

AP61053772 Issued in WA

Practice address

2525 NE 139TH St
Vancouver, WA 98686-2719

Phone

(360) 882-2778

NPI assigned

May 11, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT, OR, WA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbly19063@tvc-direct.org

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.

• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Midwife

  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• University of Utah Adult Services

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1174033989
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD (past)
• The Vancouver Clinic Pharmacy

  • Pharmacist
  • Vancouver, WA
  • NPI 1336365857
  NPD (past)
• Northwest Urology, LLC

  • Specialist
  • Portland, OR
  • NPI 1629461397
  NPD (past)
• Women'S Healthcare Associates, LLC

  • Rural Health Clinic/Center
  • Newberg, OR
  • NPI 1922987460
  NPD (past)

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1902198708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13898 NE 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986828844",
            "telephone_number": "360-541-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLY",
        "first_name": "KC",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP61053772",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "202107304NP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009003526",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500795806",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Jay Speech & Language Therapy Services, LLC
• Blue Pearl Vancouver
• Blue Sage Massage LLC
• Blue Wave Bodywork
• Lyron Blum-Evitts, LMHCA
• Stephanie Hughes Boak, M.ED, LMHC
• Shanda J Boardman
• Alin Bob, RN
• Sarah Bobbe
• Bobo Primary Care LLC

• Advanced Practice Midwife in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Advanced Practice Midwife in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.