Individual provider Active NPI

Kimberly Kay Sawyer, APRN

  • Gerontology Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1942080221
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP61441305 Issued in WA
Practice address
13510 86TH Avenue CT E
Puyallup, WA 98373-6413
Phone
(253) 241-7701
NPI assigned
Oct 3, 2023
Last updated
Dec 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP61441305 WA Primary

Addresses

Primary practice location

13510 86TH Avenue CT E
Puyallup, WA 98373-6413

Mailing address

13510 86TH Avenue CT E
Puyallup, WA 98373-6413

Other identifiers 1

IdentifierTypeStateIssuer
2270469MedicaidWA

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
I20240104004850 WA Practitioner - Nurse Practitioner 8022469980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athena Medical GroupGroup PAC ID 8921358706, 43 clinicians

Practice addresses (Care Compare)

19803 1St Ave S
Suite 200
Normandy Park, WA 98148-2410
Phone (480) 712-8319

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61441305WAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Medical Group Gerontology CurrentSince Mar 18, 2024 Accepting new patients

Locations

16515 S 40th St
Ste 143
Phoenix, AZ 85048
Phone (602) 615-0876

19803 1st Ave S
Ste 200
Normandy Park, WA 98148
Phone (206) 870-7549

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1942080221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13510 86TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983736413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13510 86TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983736413",
            "telephone_number": "253-241-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYER",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61441305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2270469",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.