NPIMap

Organization Active NPI

Whidbey Island Internal Medicine

  • Internal Medicine Physician
  • Coupeville, WA
National Provider Identifier
1003851338
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WHIDBEY ISLAND INTERNAL MEDICINE
Practice address
77 N Main St
Coupeville, WA 98239-9556
Phone
(360) 678-4440
Fax
(360) 678-9244
NPI assigned
Jun 19, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Authorized official

Name
Lee Whitney Roof, MDNPI 1407891666
Title
Owner
Phone
(360) 678-4440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

77 N Main St
Coupeville, WA 98239-9556

Mailing address

PO Box 746
Coupeville, WA 98239-9556
Phone (360) 678-4440

Other identifiers 1

IdentifierTypeStateIssuer
7094352MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1003851338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982399556",
            "telephone_number": "360-678-4440",
            "fax_number": "360-678-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982399556",
            "telephone_number": "360-678-4440",
            "fax_number": "360-678-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "ROOF",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "WHITNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-678-4440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7094352",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coupeville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.