Active NPI
James David Livermore, M.D.
- Orthopaedic Surgery Physician
- Coupeville, WA
National Provider Identifier
1093806044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD00019751
- Practice address
- 80 N. Main St.
Coupeville, WA 98239-0770 - Phone
- (360) 678-4424
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD00019751 | WA | Primary |
Addresses
Primary practice location
80 N. Main St.
Coupeville, WA 98239-0770
Mailing address
PO Box 770
Coupeville, WA 98239-0770
Phone (360) 678-4424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1350503 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00019751 | WA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1093806044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 770",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "982390770",
"telephone_number": "360-678-4424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 N. MAIN ST.",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "982390770",
"telephone_number": "360-678-4424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVERMORE",
"first_name": "JAMES",
"middle_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WA",
"license": "MD00019751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1350503",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coupeville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.