Everett Heritage Court

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

601 689 162 Issued in WA

Legal business name

EVERETT HERITAGE COURT

Practice address

4230 Colby Ave
Everett, WA 98203-2312

Phone

(425) 259-7200

Fax

(425) 339-9089

NPI assigned

Jun 18, 2008

Last updated

Jun 18, 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

Mr. Tom Brown

Title

President

Phone

(425) 259-7200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Randall S. Fisher, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Everett, WA
  • NPI 1922122811
  NPD (past)

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1285895730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032312",
            "telephone_number": "425-259-7200",
            "fax_number": "425-339-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032312",
            "telephone_number": "425-259-7200",
            "fax_number": "425-339-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT HERITAGE COURT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-259-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "WA",
            "license": "601 689 162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798861",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Everett Cardiology & Electrophysiology, P.S.
• Everett Cardiovascular and Thoracic Surgical Associates
• Everett Denture Center PLLC
• Everett E N T PS Inc
• Everett Foot Clinic PLLC
• Everett Mall Way Dental Group
• Everett Manor, LLC (Madison Villa)
• Everett MRI & Diagnostic Center LLC (Federal Way MRI & Diagnostic Center)
• Everett Optometry Clinic, PLLC
• Everett Physical Therapy and Sport Performance Center PLLC

• Exclusive Provider Organization in Everett, WA
• Providers in Everett, WA by specialty
• Exclusive Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.