Convenient Physicians Services PS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00016670 Issued in WA

Legal business name

CONVENIENT PHYSICIANS SERVICES PS

Practice address

1052 Douglas St
Longview, WA 98632-2102

Phone

(360) 425-5845

Fax

(360) 577-9066

NPI assigned

Apr 10, 2007

Last updated

Oct 9, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bert Michael Hale, MD

Title

President

Phone

(360) 425-5845

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Convenient HealthCare Other name

Practitioners 3

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.

• Clayton T Udarbe, MD

  • Family Medicine Physician
  • Vancouver, WA
  • NPI 1952384760
  NPD (past)
• Damodaran Arul Selvam, M.D.

  • Diagnostic Radiology Physician
  • Gainesville, FL
  • NPI 1093804478
  NPD (past)
• Aziz R Maksoud, MD

  • Cardiovascular Disease Physician
  • Wichita, KS
  • NPI 1003961764
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1225251390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 DOUGLAS ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322102",
            "telephone_number": "360-425-5845",
            "fax_number": "360-577-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 DOUGLAS ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322102",
            "telephone_number": "360-425-5845",
            "fax_number": "360-577-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT PHYSICIANS SERVICES PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-425-5845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00016670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "40060",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7048580",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS -WA",
            "identifier": "060706",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convenient HealthCare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Community House on Broadway
• Sally Compere, MD
• Ismael Concepcion Poo
• Brittany L Connelly
• Teresa Helen Connors, DDS
• Bailey A Conway, RN
• Gail Conway, DO
• Mackenzie Rainier Cook, MD
• Robert John Cook, PT, MHS
• Lawrence Cooney, LMT

• Family Medicine Physician in Longview, WA
• Providers in Longview, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.