NPIMap

Organization Active NPI

Roosevelt Medical Center Trust

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1215973144
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18416 Issued in WA
Legal business name
ROOSEVELT MEDICAL CENTER TRUST
Practice address
1530 N 115TH St
Suite 303
Seattle, WA 98133-8411
Phone
(206) 368-1933
Fax
(206) 368-1931
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Charles William Schneider
Title
Pres/Ceo
Phone
(206) 368-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 18416 WA Primary

Addresses

Primary practice location

1530 N 115TH St
Suite 303
Seattle, WA 98133-8411

Mailing address

1530 N 115TH St
Suite 303
Seattle, WA 98133-8411
Phone (206) 368-1933

Other names 1

  • JAMES C COGHLAN, MD Doing business as

National Provider Directory

National Provider Directory

Locations

1530 N 115th St
Ste 303
Seattle, WA 98133
Phone (206) 363-3150

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1215973144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N 115TH ST",
            "address_2": "SUITE 303",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338411",
            "telephone_number": "206-368-1933",
            "fax_number": "206-368-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N 115TH ST",
            "address_2": "SUITE 303",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338411",
            "telephone_number": "206-368-1933",
            "fax_number": "206-368-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT MEDICAL CENTER TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRES/CEO",
        "authorized_official_telephone_number": "206-368-1700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "18416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAMES C COGHLAN, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.