Organization Active NPI

Wooten Primary Care, LLC

  • Family Medicine Physician
  • Chehalis, WA
National Provider Identifier
1235186891
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WOOTEN PRIMARY CARE, LLC
Practice address
123 S Market Blvd
Chehalis, WA 98532-3037
Phone
(360) 748-9700
Fax
(360) 748-9725
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Janna Wooten
Title
Member
Phone
(360) 748-9700

Specialties & licenses 1

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

Addresses

Primary practice location

123 S Market Blvd
Chehalis, WA 98532-3037

Mailing address

123 S Market Blvd
PO Box 1245
Chehalis, WA 98532-3037
Phone (360) 748-9700

National Provider Directory

National Provider Directory

Locations

223 NW Chehalis Ave
Chehalis, WA 98532
Phone (360) 748-9700

123 S Market Blvd
Chehalis, WA 98532
Phone (360) 748-0033

Practitioners & affiliated clinicians

Practitioners 3

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235186891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S MARKET BLVD",
            "address_2": "PO BOX 1245",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323037",
            "telephone_number": "360-748-9700",
            "fax_number": "360-748-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323037",
            "telephone_number": "360-748-9700",
            "fax_number": "360-748-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOTEN PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "JANNA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-748-9700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.