NPIMap

Organization Active NPI

Franciscan Health System

  • Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1306069018
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30006578 Issued in WA
Legal business name
FRANCISCAN HEALTH SYSTEM
Practice address
1802 Yakima Ave
#102A
Tacoma, WA 98405-4499
Phone
(253) 426-6309
Fax
(253) 207-4845
NPI assigned
Apr 11, 2007
Organization subpart
Yes
Parent organization
FRANCISCAN HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Mike Fitzgerald
Title
VP, Financial Ops
Phone
(253) 552-4105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X AP30006578 WA Primary

Addresses

Primary practice location

1802 Yakima Ave
#102A
Tacoma, WA 98405-4499

Mailing address

1802 Yakima Ave
#102A
Tacoma, WA 98405-4499
Phone (253) 426-6309

Other identifiers 1

IdentifierTypeStateIssuer
9644972MedicaidWA

Other names 1

  • St Joseph Medical Center Burn Trauma Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000147 WA Part B Supplier - Clinic/Group Practice 1557254935 Receives reassigned benefits from 27 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, WA; University Place, WA; Silverdale, WA; Puyallup, WA; Lakewood, WA; Gig Harbor, WA

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Tax ID family
Franciscan HLTH System West24 organizations share this tax ID, including this one
Part of
Franciscan HLTH System West

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

1802 Yakima Ave
#102A
Tacoma, WA 98405
Phone (253) 426-6309

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1306069018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE",
            "address_2": "#102A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054499",
            "telephone_number": "253-426-6309",
            "fax_number": "253-207-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE",
            "address_2": "#102A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054499",
            "telephone_number": "253-426-6309",
            "fax_number": "253-207-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN HEALTH SYSTEM",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP, FINANCIAL OPS",
        "authorized_official_telephone_number": "253-552-4105"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9644972",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Joseph Medical Center Burn Trauma Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.