Individual provider Active NPI

Kelly Sweerus

  • Pulmonary Disease Physician
  • Seattle, WA
National Provider Identifier
1992968499
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD60431899 Issued in WA
Practice address
515 Minor Ave
Seattle, WA 98104-2120
Phone
(206) 386-9500
Fax
(206) 576-3802
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X A115721 CA
Student in an Organized Health Care Education/Training Program 390200000X 4301092101 MI
Pulmonary Disease Physician 207RP1001X MD60431899 WA Primary

Addresses

Primary practice location

515 Minor Ave
Seattle, WA 98104-2120

Mailing address

515 Minor Ave
Seattle, WA 98104-2120
Phone (206) 386-9500

Other practice location 1

5350 Tallman Ave NW Ste 301
Seattle, WA 98107-5902
Phone (206) 320-2961

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksweerus973024@wm.providencedirect.org Direct

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60431899WAMDPulmonary Disease Physician
4301092101MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1992968499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042120",
            "telephone_number": "206-386-9500",
            "fax_number": "206-576-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042120",
            "telephone_number": "206-386-9500",
            "fax_number": "206-576-3802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5350 Tallman Ave NW Ste 301",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075902",
            "country_code": "US",
            "telephone_number": "206-320-2961",
            "fax_number": "206-991-2061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWEERUS",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A115721",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301092101",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60431899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksweerus973024@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5350 Tallman Ave NW Ste 301",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981075902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.