Individual provider Active NPI

Joshua Raymond Kistner, D.O.

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1942620307
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60768569 Issued in WA
Practice address
5921 N Market St
Spokane, WA 99208
Phone
(094) 444-8200
Fax
(509) 482-6286
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-1287 ID
Family Medicine Physician 207Q00000X OP60768569 WA Primary

Addresses

Primary practice location

5921 N Market St
Spokane, WA 99208

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180705001030 WA Practitioner - Family Practice 5597011577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5921 N Market St
Spokane, WA 99208-2484
Phone (509) 487-1604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O-1287IDMDFamily Medicine Physician
OP60768569WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane CurrentSince Jun 1, 2018 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane CurrentSince Jun 1, 2018 Accepting new patients

Locations

5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

611 N Iron Bridge Way
Spokane, WA 99202

203 N Washington St
Ste 300
Spokane, WA 99201

Interoperability endpoints

  • Direct secure messaging: joshua.kistner.1@11411.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1942620307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 N MARKET ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "094-444-8200",
            "fax_number": "509-482-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTNER",
        "first_name": "JOSHUA",
        "middle_name": "RAYMOND",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1287",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60768569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.