Individual provider Active NPI

Linda Washington Fory, MD

  • Pediatrics Physician
  • Lompoc, CA
National Provider Identifier
1073685814
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A73101 Issued in CA
Practice address
425 W Central Ave Ste 201
Lompoc, CA 93436-2807
Phone
(372) 080-5737
Fax
(805) 737-1772
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60481573 WA
Pediatrics Physician 208000000X A73101 CA Primary

Addresses

Primary practice location

425 W Central Ave Ste 201
Lompoc, CA 93436-2807

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8028

Other identifiers 1

IdentifierTypeStateIssuer
00A731010MedicaidCA

Other names 1

  • Linda Karen Washington Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000206 CA Practitioner - Pediatric Medicine 8022206622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A73101CAMDPediatrics Physician
MD60481573WAMDPediatrics Physician
73101CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc CurrentSince Sep 1, 2017 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Sep 1, 2017 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

425 W Central Ave
Ste 201
Lompoc, CA 93436
Phone (805) 681-5323

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1073685814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8028",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W CENTRAL AVE STE 201",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934362807",
            "telephone_number": "372-080-5737",
            "fax_number": "805-737-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORY",
        "first_name": "LINDA",
        "middle_name": "WASHINGTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60481573",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A73101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A731010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "WASHINGTON",
            "middle_name": "KAREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.