NPIMap

Organization Active NPI

Franciscan Health System

Doing business as Franciscan Psychology-Neuropsychology Services @ St Clare

  • Psychologist
  • Lakewood, WA
National Provider Identifier
1093952145
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
FRANCISCAN HEALTH SYSTEM
Doing business as
Franciscan Psychology-Neuropsychology Services @ St Clare
Practice address
4908 112TH St SW
Lakewood, WA 98499-5143
Phone
(253) 985-6560
Fax
(253) 985-6561
NPI assigned
Jan 12, 2009
Last updated
Feb 5, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Mike Fitzgerald
Title
VP Financial Ops
Phone
(253) 680-4005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

4908 112TH St SW
Lakewood, WA 98499-5143

Mailing address

4908 112TH St SW
Lakewood, WA 98499-5143
Phone (253) 985-6560

Other names 1

  • Franciscan Psychology-Neuropsychology Services @ St Clare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000147 WA Part B Supplier - Clinic/Group Practice 1557254935 Receives reassigned benefits from 27 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, WA; University Place, WA; Silverdale, WA; Puyallup, WA; Lakewood, WA; Gig Harbor, WA

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Part of
Franciscan HLTH System West

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1093952145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 112TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984995143",
            "telephone_number": "253-985-6560",
            "fax_number": "253-985-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 112TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984995143",
            "telephone_number": "253-985-6560",
            "fax_number": "253-985-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN HEALTH SYSTEM",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP FINANCIAL OPS",
        "authorized_official_telephone_number": "253-680-4005"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franciscan Psychology-Neuropsychology Services @ St Clare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.