Individual provider Active NPI

William Douglas Trotter, M.D.

  • Family Medicine Physician
  • Snohomish, WA
National Provider Identifier
1336163351
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00021635 Issued in WA
Practice address
629 Avenue D
Snohomish, WA 98290-2330
Phone
(360) 568-1554
Fax
(360) 568-1722
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00021635 WA Primary

Addresses

Primary practice location

629 Avenue D
Snohomish, WA 98290-2330

Mailing address

629 Avenue D
Snohomish, WA 98290-2330
Phone (360) 568-1554

Other identifiers 2

IdentifierTypeStateIssuer
080172063OtherWAMEDICARE RAILROAD
8623704MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826000241 WA Practitioner - Family Practice 1759405855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00021635WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Washington Medical Group, Inc PS CurrentSince Jan 1, 2015 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jan 1, 2015 Accepting new patients
Western Washington Medical Group, Inc PS Current Accepting new patients

Locations

7315 212th St SW
Ste 101
Edmonds, WA 98026
Phone (425) 670-3550

4225 Hoyt Ave
Ste A
Everett, WA 98203
Phone (425) 259-3122

1728 W Marine View Dr
Ste 111
Everett, WA 98201

629 Avenue D
Snohomish, WA 98290
Phone (360) 568-1551

Organizations & group practices 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1336163351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 AVENUE D",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902330",
            "telephone_number": "360-568-1554",
            "fax_number": "360-568-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 AVENUE D",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902330",
            "telephone_number": "360-568-1554",
            "fax_number": "360-568-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTTER",
        "first_name": "WILLIAM",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00021635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080172063",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8623704",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snohomish, WA

Sources for this page

Verify at the official NPI Registry.