NPIMap

Organization Active NPI

South Sound Inpatient Physicians, PLLC

  • Hospitalist Physician
  • Silverdale, WA
National Provider Identifier
1063854859
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
SOUTH SOUND INPATIENT PHYSICIANS, PLLC
Practice address
1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone
(360) 337-8800
NPI assigned
Jul 23, 2013
Last updated
Jul 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
James Kodjababian
Title
Cro
Phone
(253) 682-1710

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

1800 NW Myhre Rd
Silverdale, WA 98383-7663

Mailing address

1123 Pacific Ave
Tacoma, WA 98402-4303
Phone (253) 682-1710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000668 WA Part B Supplier - Clinic/Group Practice 5991618738 Receives reassigned benefits from 958 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 155

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.

View all 155

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1063854859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024303",
            "telephone_number": "253-682-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837663",
            "telephone_number": "360-337-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND INPATIENT PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "KODJABABIAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "253-682-1710"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.