NPIMap

Organization Active NPI

Franciscan Medical Group

Doing business as FMG-Thoracic and Vascular Center of Kitsap Co.

  • Vascular Surgery Physician
  • Bremerton, WA
National Provider Identifier
1336386473
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
FMG-Thoracic and Vascular Center of Kitsap Co.
Practice address
1225 Campbell Way
Suite 101
Bremerton, WA 98310-3351
Phone
(360) 479-4203
Fax
(360) 478-7240
NPI assigned
Jan 12, 2009
Last updated
Jan 12, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Cliff A. Robertson, MD
Title
Ceo
Phone
(253) 779-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X WA Primary

Addresses

Primary practice location

1225 Campbell Way
Suite 101
Bremerton, WA 98310-3351

Mailing address

1225 Campbell Way
Suite 101
Bremerton, WA 98310-3351
Phone (360) 479-4203

Other names 1

  • FMG-Thoracic and Vascular Center of Kitsap Co. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CHI Franciscan Health19 organizations share this tax ID, including this one
Part of
CHI Franciscan Health

Other organizations with this tax ID 18

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

View all 18

Locations

1225 Campbell Way
Ste 101
Bremerton, WA 98310
Phone (360) 479-4203

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1336386473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CAMPBELL WAY",
            "address_2": "SUITE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103351",
            "telephone_number": "360-479-4203",
            "fax_number": "360-478-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CAMPBELL WAY",
            "address_2": "SUITE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103351",
            "telephone_number": "360-479-4203",
            "fax_number": "360-478-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-779-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMG-Thoracic and Vascular Center of Kitsap Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.