Henry L Degive, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00017990 Issued in WA

Practice address

3516 12TH Ave NE
Olympia, WA 98506-5218

Phone

(360) 918-0604

Fax

(360) 456-6504

NPI assigned

Oct 4, 2006

Last updated

Apr 21, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• South Sound Pediatrics PLLC

  • Pediatrics Physician
  • Olympia, WA
  • NPI 1073684692
  NPD (past)
• South Sound Pediatrics PLLC

  dba South Sound Pediatrics

  • Pediatrics Physician
  • Olympia, WA
  • NPI 1578001186
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1114012036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-918-0604",
            "fax_number": "360-456-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-918-0604",
            "fax_number": "360-456-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGIVE",
        "first_name": "HENRY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00017990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002662",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenna Alise Decker
• Dana Decosta-Peiler, BCBA, LBA
• Lindsey Decremer, DPT
• John Deffenbaugh
• Ghea Mae Tiping Degillo, DNP
• Stephanie Muyargas Degroff
• Eliza Deguzman, PHARMD
• Cornelis Dehart Jr., MD
• David Michael Deitz, MD
• Andrew Dejesus, CNIM

• Pediatrics Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.