Active NPI
Mark Stephen Flanagan, MD
- Surgery Physician
- Olympia, WA
National Provider Identifier
1154457257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- PT 10464
- Practice address
- 700 Lilly Road NE
Group Health
Olympia, WA 98506-5196 - Phone
- (360) 923-7530
- Fax
- (360) 923-7599
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | PT 10464 | ND | Primary |
| Surgery Physician | 208600000X | 10464 | ND |
Addresses
Primary practice location
700 Lilly Road NE
Group Health
Olympia, WA 98506-5196
Mailing address
320 Westlake Ave N
Suite 100, 6HQ, E2N, 6HP Group Health Permanente
Seattle, WA 98109
Phone (206) 448-6192
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 10464 | ND | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216598400000",
"number": "1154457257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 WESTLAKE AVE N",
"address_2": "SUITE 100, 6HQ, E2N, 6HP GROUP HEALTH PERMANENTE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98109",
"telephone_number": "206-448-6192",
"fax_number": "206-877-0652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LILLY ROAD NE",
"address_2": "GROUP HEALTH",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065196",
"telephone_number": "360-923-7530",
"fax_number": "360-923-7599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANAGAN",
"first_name": "MARK",
"middle_name": "STEPHEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2008-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ND",
"license": "PT 10464",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ND",
"license": "10464",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.