NPIMap

Organization Active NPI

Franciscan Health System

Doing business as Franciscan Psychology-Neuropsychology Services @ St Joseph

  • Clinical Psychologist
  • Tacoma, WA
National Provider Identifier
1225224223
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
FRANCISCAN HEALTH SYSTEM
Doing business as
Franciscan Psychology-Neuropsychology Services @ St Joseph
Practice address
1812 S J St
Ste 220
Tacoma, WA 98405-4964
Phone
(253) 426-6762
Fax
(253) 426-6224
NPI assigned
Sep 24, 2007
Last updated
Feb 5, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Mike Fitzgerald
Title
VP Financial Operations
Phone
(253) 552-4105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X WA Primary

Addresses

Primary practice location

1812 S J St
Ste 220
Tacoma, WA 98405-4964

Mailing address

1812 S J St
Ste 220
Tacoma, WA 98405-4964
Phone (253) 426-6762

Other identifiers 3

IdentifierTypeStateIssuer
0224795OtherWASTATE L&I
7139231MedicaidWA
8907052OtherWASTATE CRIME VICTIMS

Other names 1

  • Franciscan Psychology-Neuropsychology Services @ St Joseph Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000147 WA Part B Supplier - Clinic/Group Practice 1557254935 Receives reassigned benefits from 27 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, WA; University Place, WA; Silverdale, WA; Puyallup, WA; Lakewood, WA; Gig Harbor, WA

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Part of
St Joseph Hospital Lab

Locations

1812 S J St
Ste 220
Tacoma, WA 98405
Phone (253) 426-6762

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1225224223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "STE 220",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-426-6762",
            "fax_number": "253-426-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "STE 220",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-426-6762",
            "fax_number": "253-426-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN HEALTH SYSTEM",
        "enumeration_date": "2007-09-24",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP FINANCIAL OPERATIONS",
        "authorized_official_telephone_number": "253-552-4105"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0224795",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7139231",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8907052",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franciscan Psychology-Neuropsychology Services @ St Joseph",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 5, 2009; 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.