Jason David Fodeman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD456893 Issued in PA

Practice address

7273 Linderson Way SW
Tumwater, WA 98501-5414

Phone

(360) 902-5511

NPI assigned

Sep 14, 2009

Last updated

Jan 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1023341690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44321",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985044321",
            "telephone_number": "360-902-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7273 LINDERSON WAY SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015414",
            "telephone_number": "360-902-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODEMAN",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD456893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew M Flojo, LMP
• Alex Flores, L.AC, EAMP
• Zachary Flores
• Flu Shots by Nurse Janet, Inc.
• Abraham Gamanga Foday
• Foot and Ankle Surgical Associates Inc PS
• Mark A Forstrom Sr.
• Eric William Forsythe, A.T.C.
• Chelsea Fosmire
• Jennifer Foster Hinman, LMT

• Internal Medicine Physician in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.