NPIMap

Organization Active NPI

Harkness Medical Group, PLLC

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1215518113
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HARKNESS MEDICAL GROUP, PLLC
Practice address
412 Black Hills LN SW Ste a
Olympia, WA 98502-8142
Phone
(360) 567-6064
Fax
(833) 731-0392
NPI assigned
Apr 21, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Ross Harkness
Title
Owner
Phone
(785) 410-5472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

412 Black Hills LN SW Ste a
Olympia, WA 98502-8142

Mailing address

412 Black Hills LN SW Ste a
Olympia, WA 98502-8142
Phone (360) 567-6064

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210611002609 WA Part B Supplier - Clinic/Group Practice 5698175669 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

Locations

412 Black Hills Ln SW
Ste A
Olympia, WA 98502
Phone (360) 528-2100

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1215518113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 BLACK HILLS LN SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028142",
            "telephone_number": "360-567-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 BLACK HILLS LN SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028142",
            "telephone_number": "360-567-6064",
            "fax_number": "833-731-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARKNESS MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "HARKNESS",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-410-5472"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 27, 2021; 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.