NPIMap

Organization Active NPI

Ridgefield Family Medicine, PLLC

  • Family Medicine Physician
  • Ridgefield, WA
National Provider Identifier
1245338227
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIDGEFIELD FAMILY MEDICINE, PLLC
Practice address
8507 South 5TH Street
Suite 113
Ridgefield, WA 98642
Phone
(360) 887-9494
Fax
(360) 887-9498
NPI assigned
Sep 21, 2006
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Sharon Ann Houghton
Title
Clinic Manager
Phone
(360) 887-9494

Specialties & licenses 1

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

Addresses

Primary practice location

8507 South 5TH Street
Suite 113
Ridgefield, WA 98642

Mailing address

PO Box 8904
Vancouver, WA 98668-8904
Phone (360) 887-9494

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130222000001 WA Part B Supplier - Clinic/Group Practice 4981639473 Receives reassigned benefits from 10 practitioners
Practice locations: Ridgefield, WA

National Provider Directory

National Provider Directory

Locations

8507 S 5th St
Ridgefield, WA 98642
Phone (360) 887-5839

1331 N Goerig St
Woodland, WA 98674
Phone (360) 887-9494

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7156/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1245338227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8904",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986688904",
            "telephone_number": "360-887-9494",
            "fax_number": "360-887-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 SOUTH 5TH STREET",
            "address_2": "SUITE 113",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "98642",
            "telephone_number": "360-887-9494",
            "fax_number": "360-887-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEFIELD FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "HOUGHTON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "360-887-9494"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.