Individual provider Active NPI

Leslie S Newton, MD

  • Family Medicine Physician
  • Lake Forest Park, WA
National Provider Identifier
1124024476
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00013244 Issued in WA
Practice address
17191 Bothell Way NE
Ste 205
Lake Forest Park, WA 98155-5534
Phone
(206) 364-8272
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00013244 WA Primary

Addresses

Primary practice location

17191 Bothell Way NE
Ste 205
Lake Forest Park, WA 98155-5534

Mailing address

17191 Bothell Way NE
Ste 205
Lake Forest Park, WA 98155-5534
Phone (206) 364-8272

Other identifiers 3

IdentifierTypeStateIssuer
080181372OtherWARAILROAD MEDICARE
1629609MedicaidWA
GAB25977OtherMEDICARE GROUP

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

LicenseStateTypeSpecialty
MD00013244WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1124024476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17191 BOTHELL WAY NE",
            "address_2": "STE 205",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981555534",
            "telephone_number": "206-364-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17191 BOTHELL WAY NE",
            "address_2": "STE 205",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981555534",
            "telephone_number": "206-364-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "LESLIE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00013244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080181372",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629609",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GAB25977",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.