NPIMap

Organization Active NPI

Frandsen Family Medicine PS

  • Primary Care Clinic/Center
  • Port Orchard, WA
National Provider Identifier
1306971296
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD00029864 Issued in WA
Legal business name
FRANDSEN FAMILY MEDICINE PS
Practice address
463 Tremont St W
Ste 200
Port Orchard, WA 98366-0000
Phone
(360) 876-2434
Fax
(360) 876-2696
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Authorized official

Name
Brad R Frandsen, M.D.NPI 1700820966
Title
President
Phone
(360) 876-2434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD00029864 WA Primary

Addresses

Primary practice location

463 Tremont St W
Ste 200
Port Orchard, WA 98366-0000

Mailing address

463 Tremont St W
Ste 200
Port Orchard, WA 98366-3743
Phone (360) 876-2434

Other identifiers 1

IdentifierTypeStateIssuer
7134620MedicaidWA

Other names 1

  • Sound Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070402000277 WA Part B Supplier - Clinic/Group Practice 5092819011 Receives reassigned benefits from 7 practitioners
Practice locations: Port Orchard, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1059615Sound Health Care Center463 Tremont St W Ste 200, Port Orchard, WA 98366Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1306971296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W",
            "address_2": "STE 200",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663743",
            "telephone_number": "360-876-2434",
            "fax_number": "360-876-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W",
            "address_2": "STE 200",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983660000",
            "telephone_number": "360-876-2434",
            "fax_number": "360-876-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANDSEN FAMILY MEDICINE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "FRANDSEN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-876-2434",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "MD00029864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7134620",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sound Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.