Northwest Surgical Group PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00029497 Issued in WA

Legal business name

NORTHWEST SURGICAL GROUP PC

Practice address

3920 Capitol Mall Dr SW
Suite 201
Olympia, WA 98502-8700

Phone

(360) 754-1029

Fax

(390) 754-7885

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

William Clarence Williard, M.D.

Title

Physician

Phone

(360) 754-1029

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher S Johnson, P.A.

  • Surgical Physician Assistant
  • Olympia, WA
  • NPI 1295778165
  NPD (past)
• Michael V Novia, M.D.

  • Plastic Surgery Physician
  • Olympia, WA
  • NPI 1679604482
  NPD (past)
• Robert Steven Norton, MD

  • Surgery Physician
  • Visalia, CA
  • NPI 1013961366

  Specialist

  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1114957875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 CAPITOL MALL DR SW",
            "address_2": "SUITE 201",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028700",
            "telephone_number": "360-754-1029",
            "fax_number": "390-754-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 CAPITOL MALL DR SW",
            "address_2": "SUITE 201",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028700",
            "telephone_number": "360-754-1029",
            "fax_number": "390-754-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "WILLIARD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "360-754-1029",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "601009261",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00029497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105182",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Radiology Group LLC
• Northwest Resources II
• Northwest Resources II
• Northwest Resources II
• Northwest Smile Dental and Denture
• Northwest Vision Center, P.C.
• Shelly Ann Norvell, OTR
• Julie Norwood, LMHCA
• Janet Notarianni, PTA
• Ryan Phoenix Nottingham, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.