Supriya A Kang, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD00047610 Issued in WA

Practice address

5455 Almira Dr NE
Bremerton, WA 98311-8331

Phone

(360) 415-3932

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Public Hospital District 2 of Snohomish County

  • Pain Clinic/Center
  • Edmonds, WA
  • NPI 1407167513
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1942411533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118331",
            "telephone_number": "360-415-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118331",
            "telephone_number": "360-415-3932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15418 Main St",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980129030",
            "country_code": "US",
            "telephone_number": "425-339-5453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "SUPRIYA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00047610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034868",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaiser Foundation Health Plan of Washington
• Kaiser Foundation Health Plan of Washington
• Allison Kaye Kamahele
• Makena Kailani Kamaka
• Christy Ryu Kang, PHARMD
• Kayla S Kangiser, RDN, CDCES
• Rapin Chai Kanithanon, MD
• Andrea Dioresa Kantor
• Karen A Karadimov, MSW
• David Karn

• Psychiatry Physician in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.