Thomas Harris, DO – Family Medicine Physician

Key facts

NPI: 1083680201
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 1446 (WA)
Practice address: 1201 Pacific Ave Ste 400
Tacoma, WA 98402-4381
Phone: (253) 319-8146
NPI assigned: Feb 27, 2006
Sex: Male
Sole proprietor: Yes

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.

Inpatient Consultants of California, Inc. Hospitalist Physician · Berkeley, CA · NPI 1487930541

Medicare reassignment NPD WA
Inpatient Consultants of California, Inc Internal Medicine Physician · Riverside, CA · NPI 1992189286

NPD FAMILY MEDICINE
Freeland Clinic Inc Primary Care Clinic/Center · Freeland, WA · NPI 1003962408

NPD (past) FAMILY MEDICINE
Regency Coupeville, LLC Skilled Nursing Facility · Coupeville, WA · NPI 1508864935

NPD (past)
Susan J Jones, Arnp MSN PLLC Family Nurse Practitioner · Freeland, WA · NPI 1316268584

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20050228000177	WA	Practitioner - Family Practice	7012960321	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Practice roles

Organization	Specialty	Status	New patients
Inpatient Consultants of California, Inc.		Current since Jan 1, 2018	Accepting new patients
Inpatient Consultants of California, Inc	Family Medicine	Current since Jan 1, 2018	Accepting new patients
Susan J Jones, Arnp MSN PLLC		Past since Aug 1, 2010	Accepting new patients
Regency Coupeville, LLC		Past	Accepting new patients
Freeland Clinic Inc	Family Medicine	Past	Accepting new patients

Locations

1919 112th St SW
Everett, WA 98204
Phone (425) 249-0024

80 SW 2nd St
Renton, WA 98057
Phone (425) 226-4510

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	1446	WA	Yes
Family Medicine Physician	207Q00000X	OP00001446	WA

Addresses

Primary practice location

1201 Pacific Ave Ste 400
Tacoma, WA 98402-4381

Mailing address

5548 Myrtle Ave
#201
Freeland, WA 98249
Phone (360) 331-3391

Other practice location 1

5548 Myrtle Ave
#201
Freeland, WA 98249
Phone (360) 331-3391

Other identifiers

Identifier	Type	State	Issuer
1002010	Medicaid	WA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 1, 2021.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1083680201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5548 MYRTLE AVE",
            "address_2": "#201",
            "city": "FREELAND",
            "state": "WA",
            "postal_code": "98249",
            "telephone_number": "360-331-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PACIFIC AVE STE 400",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024381",
            "telephone_number": "253-319-8146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5548 Myrtle Ave",
            "address_2": "#201",
            "address_purpose": "LOCATION",
            "city": "Freeland",
            "state": "WA",
            "postal_code": "98249",
            "country_code": "US",
            "telephone_number": "360-331-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "1446",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001446",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002010",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

All providers in Tacoma, WA · Family Medicine Physician in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.