Individual provider Active NPI

Virgil Gene Livingston, MD-DPM

  • Foot & Ankle Surgery Podiatrist
  • Vancouver, WA
National Provider Identifier
1265164198
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO00000166 Issued in WA
Practice address
12411 NE 70TH Cir
Vancouver, WA 98682-4885
Phone
(602) 615-9915
NPI assigned
Jun 29, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X PO00000166 WA
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X PO00000166 WA Primary

Addresses

Primary practice location

12411 NE 70TH Cir
Vancouver, WA 98682-4885

Mailing address

12411 NE 70TH Cir Ste 106
Vancouver, WA 98682-4885
Phone (602) 615-9915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230106000723 WA Practitioner - Podiatry 9638288830 Reassigns benefits to 1 organization
I20230829001024 OR Practitioner - Podiatry 9638288830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO00000166WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Foot and Ankle Clinic, LLC Multi-Specialty Current Accepting new patients
Columbia Foot and Ankle Clinic, LLC Multi-Specialty CurrentSince Nov 11, 2023 Accepting new patients
Columbia Foot and Ankle Clinic-Virgil Gene Livinston Multi-Specialty CurrentSince Dec 17, 2023 Accepting new patients
Medassure Inc PastSince Mar 27, 2009 Accepting new patients

Locations

5701 SW Multnomah Blvd
Portland, OR 97219
Phone (503) 244-1107

16485 SW Pacific Hwy
Tigard, OR 97224
Phone (503) 620-5141

11120 NE 33rd Pl
Ste 202
Bellevue, WA 98004
Phone (206) 426-2584

1500 3rd Ave
Longview, WA 98632
Phone (360) 423-8800

153 Johns Ct
Shelton, WA 98584
Phone (360) 427-2575

19235 15th Ave NW
Shoreline, WA 98177
Phone (206) 546-2666

7202 NE Highway 99
Ste 106
Vancouver, WA 98665
Phone (360) 207-4504

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1265164198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12411 NE 70TH CIR STE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986824885",
            "telephone_number": "602-615-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12411 NE 70TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986824885",
            "telephone_number": "602-615-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "VIRGIL",
        "middle_name": "GENE",
        "credential": "MD-DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000166",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.