Organization Active NPI

Madrona Medical Group,PS

  • Radiology Clinic/Center
  • Bellingham, WA
National Provider Identifier
1073602991
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MADRONA MEDICAL GROUP,PS
Practice address
4545 Cordata Pkwy
Bellingham, WA 98226-7123
Phone
(360) 738-2200
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Sandy Mellott
Title
Director Clinical Services
Phone
(360) 738-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X WA Primary

Addresses

Primary practice location

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Mailing address

4545 Cordata Pkwy
Bellingham, WA 98226-7123
Phone (360) 738-2200

National Provider Directory

National Provider Directory

Locations

4545 Cordata Pkwy
#1D
Bellingham, WA 98226
Phone (360) 752-5621

4545 Cordata Pkwy
Ste 1A
Bellingham, WA 98226
Phone (360) 733-7687

4465 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 752-5206

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1073602991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA MEDICAL GROUP,PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "MELLOTT",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "DIRECTOR CLINICAL SERVICES",
        "authorized_official_telephone_number": "360-738-2200"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.