Active NPI
Robert William Enquist, MD
- Military Health Care Provider
- Tacoma, WA
National Provider Identifier
1194790766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- MD00012919
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-1719 - Phone
- (253) 581-2775
- Fax
- (253) 581-2776
- NPI assigned
- Feb 17, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | MD00012919 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-1719
Mailing address
136 Cormorant Dr
Steilacoom, WA 98388-1719
Phone (253) 581-2775
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00012919 | Other | WA | US ARMY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | MAMC | Health Information Exchange (HIE) | |
| CONNECT URL | MAMC | Direct |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00012919 | WA | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1194790766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 CORMORANT DR",
"city": "STEILACOOM",
"state": "WA",
"postal_code": "983881719",
"telephone_number": "253-581-2775",
"fax_number": "253-581-2776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311719",
"telephone_number": "253-581-2775",
"fax_number": "253-581-2776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENQUIST",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "WA",
"license": "MD00012919",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US ARMY",
"identifier": "00012919",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "MAMC",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct",
"address_1": "Madigan Amc N 18th St Bldgr6100",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984311719",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "MAMC",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "None",
"address_1": "Madigan Amc N 18th St Bldgr6100",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984311719",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.