Montesano Internal Medicine, PS

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MONTESANO INTERNAL MEDICINE, PS

Practice address

112 E Broadway Ave
Montesano, WA 98563-3704

Phone

(360) 249-4111

Fax

(360) 249-5220

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Yong Ki Shin, MDNPI 1851364988

Title

President and Co-Owner

Phone

(360) 249-4111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

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.

• Yong Ki Shin, M.D.

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1851364988
  Medicare reassignment NPD Authorized official
• Karen Lisa Arndt, ARNP

  • Family Nurse Practitioner
  • Montesano, WA
  • NPI 1104995596
  Medicare reassignment NPD
• Clara Chon Shin, M.D.

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1376516401
  Medicare reassignment NPD
• Nathan Howard Valentine, FNP-BC

  • Family Nurse Practitioner
  • Aberdeen, WA
  • NPI 1154707552
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1073683314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E BROADWAY AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633704",
            "telephone_number": "360-249-4111",
            "fax_number": "360-249-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E BROADWAY AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633704",
            "telephone_number": "360-249-4111",
            "fax_number": "360-249-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTESANO INTERNAL MEDICINE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "YONG",
        "authorized_official_middle_name": "KI",
        "authorized_official_title_or_position": "PRESIDENT AND CO-OWNER",
        "authorized_official_telephone_number": "360-249-4111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn McManus
• Juan Miguel Fernandez Mendoza, PT
• Mens Pharmacy LLC (MENS Pharmacy)
• Gina Renee Miles, LICSW
• Judith J Miller, ARNP
• Montesano Physical Therapy Inc.
• Montesano School District
• Montesano Spa Works and Massage, LLC
• Montesano Vision Center PLLC
• Kendra Alexis Morscheck, DPT

• Internal Medicine Physician in Montesano, WA
• Providers in Montesano, 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 Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.