Organization Active NPI

Northwest Medical Group PLLC

  • Occupational Medicine Physician
  • Moses Lake, WA
National Provider Identifier
1154006492
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
NORTHWEST MEDICAL GROUP PLLC
Practice address
938 W 3Rd Ave
Moses Lake, WA 98837-2011
Phone
(509) 350-4785
Fax
(509) 380-9591
NPI assigned
Jun 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Dr. Brandon Penix, DO, MPHNPI 1164784088
Title
Owner
Phone
(509) 350-4785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WX0106X
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0500X
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X
Occupational Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083X0100X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

938 W 3Rd Ave
Moses Lake, WA 98837-2011

Mailing address

938 W 3Rd Ave
Moses Lake, WA 98837-2011
Phone (509) 350-4785

Other practice location 1

1240 S Pioneer Way Ste A
Moses Lake, WA 98837-2347
Phone (509) 350-4785

Other identifiers 1

IdentifierTypeStateIssuer
0471864OtherWALABOR AND INDUSTRIES

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2273497Northwest Medical Group PLLC938 West Third Ave, Moses Lake, WA 98837Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

938 W 3rd Ave
Moses Lake, WA 98837
Phone (509) 350-4785

821 E Broadway Ave
Ste 1
Moses Lake, WA 98837
Phone (509) 350-4785

1240 S Pioneer Way
#A
Moses Lake, WA 98837
Phone (509) 350-4785

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJGAA
  • FHIR API: https://api.platform.athenahealth.com/2340/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1154006492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 W 3RD AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372011",
            "telephone_number": "509-350-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 W 3RD AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372011",
            "telephone_number": "509-350-4785",
            "fax_number": "509-380-9591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 S Pioneer Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988372347",
            "country_code": "US",
            "telephone_number": "509-350-4785",
            "fax_number": "509-380-9591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "PENIX",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-350-4785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, MPH"
    },
    "taxonomies": [
        {
            "code": "163WX0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Occupational Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0471864",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.