Individual provider Active NPI

Janis Maryan Mercker, MD

  • Diagnostic Radiology Physician
  • Everett, WA
National Provider Identifier
1124164900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00016263 Issued in WA
Practice address
728 134TH St SW
Suite 120
Everett, WA 98204-5322
Phone
(425) 297-6200
Fax
(425) 297-6250
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00016263 WA Primary

Addresses

Primary practice location

728 134TH St SW
Suite 120
Everett, WA 98204-5322

Mailing address

18009 13TH Ave NW
Shoreline, WA 98177-3203
Phone (206) 542-5407

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
MD00016263WAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124164900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18009 13TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773203",
            "telephone_number": "206-542-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 134TH ST SW",
            "address_2": "SUITE 120",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982045322",
            "telephone_number": "425-297-6200",
            "fax_number": "425-297-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCKER",
        "first_name": "JANIS",
        "middle_name": "MARYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00016263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

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

Verify at the official NPI Registry.