Active NPI
Diane M Kalvelage, ARNP
- Nurse Practitioner
- Mountlake Terrace, WA
National Provider Identifier
1932183514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP300004001
- Practice address
- 6005 244TH St SW
Ste 111
Mountlake Terrace, WA 98043-5400 - Phone
- (425) 275-5555
- Fax
- (425) 275-5590
- NPI assigned
- Dec 6, 2005
- Last updated
- Apr 7, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP300004001 | WA | Primary |
Addresses
Primary practice location
6005 244TH St SW
Ste 111
Mountlake Terrace, WA 98043-5400
Mailing address
6005 244TH St SW
Ste 111
Mountlake Terrace, WA 98043-5400
Phone (425) 275-5555
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP300004001 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Urology Consultants LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207526400000",
"number": "1932183514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6005 244TH ST SW",
"address_2": "STE 111",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980435400",
"telephone_number": "425-275-5555",
"fax_number": "425-275-5590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6005 244TH ST SW",
"address_2": "STE 111",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980435400",
"telephone_number": "425-275-5555",
"fax_number": "425-275-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALVELAGE",
"first_name": "DIANE",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-06",
"last_updated": "2008-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP300004001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountlake Terrace, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.