NPIMap

Organization Active NPI

Telehealth Medical Group

  • Family Medicine Physician
  • Kirkland, WA
National Provider Identifier
1063928281
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TELEHEALTH MEDICAL GROUP
Practice address
11415 Slater Ave NE
Kirkland, WA 98033-4656
Phone
(425) 899-2525
NPI assigned
Dec 26, 2017
Last updated
Dec 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Authorized official

Name
Dr. Bryn Jarald Henderson, DONPI 1447296694
Title
Owner
Phone
(714) 639-4012

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11415 Slater Ave NE
Kirkland, WA 98033-4656

Mailing address

615 E Chapman Ave
Orange, CA 92866-1643
Phone (714) 639-4012

National Provider Directory

National Provider Directory
Tax ID family
Telehealth Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11415 Slater Ave NE
Kirkland, WA 98033
Phone (425) 899-2525

Practitioners & affiliated clinicians

Practitioners 3

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": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1063928281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661643",
            "telephone_number": "714-639-4012",
            "fax_number": "714-639-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11415 SLATER AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980334656",
            "telephone_number": "425-899-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELEHEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "BRYN",
        "authorized_official_middle_name": "JARALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-639-4012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.