Franciscan Medical Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

FRANCISCAN MEDICAL GROUP

Doing business as

The Lakewood Clinic

Practice address

11311 Bridgeport Way SW
Ste 309
Lakewood, WA 98499-3071

Phone

(253) 779-6215

NPI assigned

Jun 24, 2008

Organization subpart

Yes

Parent organization

FRANCISCAN MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Cliff Robertson, MD

Title

President/Cmo

Phone

(253) 779-6101

Specialties & licenses 1

Addresses

Other names 1

• The Lakewood Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Part of

Enumclaw Medical Center

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1306007182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 BRIDGEPORT WAY SW",
            "address_2": "STE 309",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 BRIDGEPORT WAY SW",
            "address_2": "STE 309",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993071",
            "telephone_number": "253-779-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "PRESIDENT/CMO",
        "authorized_official_telephone_number": "253-779-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lakewood Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Franciscan Medical Group (The Lakewood Clinic)
• Franciscan Medical Group (FMG-Franciscan Plastic & reconstructive Surgery)
• Franciscan Medical Group (Lakes Family Medicine-Lakewood)
• Franciscan Medical Group (Franciscan Prompt Care on Gravelly Lake)
• Franciscan Medical Group (NW Neurology)
• Franciscan Medical Group (FMG-Franciscan Behavioral Medicine)
• Franciscan Medical Group (ROAD Clinic)
• Franciscan Medical Group (Rainier Urology)
• Franciscan Medical Group (Franciscan Vascular Associates)
• Franciscan Medical Group (Franciscan Diabetes Services)

• Pediatrics Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.