Organization Active NPI

Robert E Suchert DO PS

  • Family Medicine Physician
  • Edmonds, WA
National Provider Identifier
1205014388
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00000563 Issued in WA
Legal business name
ROBERT E SUCHERT DO PS
Practice address
617 5TH Ave S
Edmonds, WA 98020
Phone
(425) 774-5113
Fax
(425) 774-5114
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Robert E Suchert, DO PS
Title
President Owner
Phone
(425) 774-5113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OP00000563 WA Primary

Addresses

Primary practice location

617 5TH Ave S
Edmonds, WA 98020

Mailing address

PO Box 2003
Edmonds, WA 98020
Phone (425) 774-5113

Other identifiers 2

IdentifierTypeStateIssuer
040601OtherWAL AND I
1856202MedicaidWA

National Provider Directory

National Provider Directory

Locations

617 5th Ave S
Edmonds, WA 98020
Phone (206) 629-5180

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1205014388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2003",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98020",
            "telephone_number": "425-774-5113",
            "fax_number": "425-774-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 5TH AVE S",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98020",
            "telephone_number": "425-774-5113",
            "fax_number": "425-774-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E SUCHERT DO PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "SUCHERT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "425-774-5113",
        "authorized_official_credential": "DO PS"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00000563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "040601",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1856202",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.

Verify at the official NPI Registry.