Family Medical Center of Forks, Inc, PS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13422 Issued in WA

Legal business name

FAMILY MEDICAL CENTER OF FORKS, INC, PS

Doing business as

Family Medical Center

Practice address

461 G St
Forks, WA 98331-9025

Phone

(360) 374-6224

Fax

(360) 374-6039

NPI assigned

Feb 21, 2007

Last updated

Apr 20, 2008By 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. Stephen H Kriebel, MDNPI 1659374114

Title

President

Phone

(360) 374-6224

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Family Medical Center Doing business as

Practitioners 1

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.

• Stephen H Kriebel, M.D.

  • Family Medicine Physician
  • Forks, WA
  • NPI 1659374114
  NPD (past) Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1245375518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 455",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983310455",
            "telephone_number": "360-374-6224",
            "fax_number": "360-374-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 G ST",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983319025",
            "telephone_number": "360-374-6224",
            "fax_number": "360-374-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER OF FORKS, INC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KRIEBEL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-374-6224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "13422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR K NPI #",
            "identifier": "1659374114",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7020654",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7058829",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "KR9095",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA ST L&I",
            "identifier": "0048001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAURA NPI",
            "identifier": "1770509242",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8156200",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Concerned Citizens
• Kellie Linn Connery, P.T.
• Kyle Connery, DPT
• Brendan Cooney
• Richard Lee Dickson, MD
• Family Planning of Clallam County
• Felicia Mueller PLLC
• Ernest Ray Field II, MD
• Jean Carson Fletcher, ARNP
• Dayna Guillermo

• Family Medicine Physician in Forks, WA
• Providers in Forks, 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 Apr 20, 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.

Verify at the official NPI Registry.