Active NPI
Charles R Simrell, M.D.
- Clinical Pathology/Laboratory Medicine Physician
- Seattle, WA
National Provider Identifier
1225082225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- 00030432
- Practice address
- 2111 N. Northgate Way
#201
Seattle, WA 98133-0160 - Phone
- (206) 365-5171
- NPI assigned
- May 22, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 00030432 | WA | Primary |
| Anatomic Pathology Physician | 207ZP0101X | 00030432 | WA |
Addresses
Primary practice location
2111 N. Northgate Way
#201
Seattle, WA 98133-0160
Mailing address
PO Box 66500
Portland, OR 97290-6500
Phone (503) 657-8663
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225082225 | Other | WA | NPI NUMBER |
| 8188781 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00030432 | WA | MD | Clinical Pathology/Laboratory Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Pathology Services Inc | Anatomic Pathology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Pathology/Laboratory Medicine Physician
- Seattle, WA
- NPI 1518919018
Anatomic Pathology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221004800000",
"number": "1225082225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 66500",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972906500",
"telephone_number": "503-657-8663",
"fax_number": "503-723-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 N. NORTHGATE WAY",
"address_2": "#201",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981330160",
"telephone_number": "206-365-5171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMRELL",
"first_name": "CHARLES",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2008-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "WA",
"license": "00030432",
"primary": true
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "WA",
"license": "00030432",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI NUMBER",
"identifier": "1225082225",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8188781",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}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 Sep 10, 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.