NPIMap

Organization Active NPI

Swinomish Indian Tribal Community

  • Clinic/Center
  • La Conner, WA
National Provider Identifier
1164483285
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SWINOMISH INDIAN TRIBAL COMMUNITY
Practice address
17400 Reservation Rd
La Conner, WA 98257-8801
Phone
(360) 466-3167
Fax
(360) 466-5528
NPI assigned
Mar 29, 2006
Last updated
Oct 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Authorized official

Name
Mrs. Rhonda Nelson, D.P.M
Title
Clinical Applications Coordinator
Phone
(360) 466-3167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

17400 Reservation Rd
La Conner, WA 98257-8801

Mailing address

PO Box 683
La Conner, WA 98257-0683
Phone (360) 466-3167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000142 WA Part B Supplier - Clinic/Group Practice 3678477288 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: La Conner, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1164483285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 683",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982570683",
            "telephone_number": "360-466-3167",
            "fax_number": "360-466-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 RESERVATION RD",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982578801",
            "telephone_number": "360-466-3167",
            "fax_number": "360-466-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWINOMISH INDIAN TRIBAL COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "CLINICAL APPLICATIONS COORDINATOR",
        "authorized_official_telephone_number": "360-466-3167",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Conner, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.