NPIMap

Organization Active NPI

The Foot and Ankle Center of Kirkland PLLC

  • Foot & Ankle Surgery Podiatrist
  • Kirkland, WA
National Provider Identifier
1922485564
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO60204241 Issued in WA
Legal business name
THE FOOT AND ANKLE CENTER OF KIRKLAND PLLC
Practice address
13114 120TH Ave NE
Kirkland, WA 98034-3014
Phone
(425) 947-2880
Fax
(800) 554-8144
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Dr. Stephanie E Kim, DPMNPI 1093946444
Title
Physician/Owner
Phone
(425) 947-2880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO60204241 WA Primary

Addresses

Primary practice location

13114 120TH Ave NE
Kirkland, WA 98034-3014

Mailing address

6947 Coal Creek Pkwy SE
#753
Newcastle, WA 98059-3136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150710002579 WA Part B Supplier - Clinic/Group Practice 4789996216 Receives reassigned benefits from 3 practitioners
Practice locations: Kirkland, WA

National Provider Directory

National Provider Directory

Locations

12039 NE 128th St
Ste 130
Kirkland, WA 98034

6947 Coal Creek Pkwy SE
Newcastle, WA 98059
Phone (206) 229-7984

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1922485564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6947 COAL CREEK PKWY SE",
            "address_2": "#753",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980593136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13114 120TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343014",
            "telephone_number": "425-947-2880",
            "fax_number": "800-554-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOOT AND ANKLE CENTER OF KIRKLAND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "425-947-2880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO60204241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.