Organization Active NPI

John P. Hackett, MD, P.S.

  • Dermatology Physician
  • Bellevue, WA
National Provider Identifier
1346412905
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00013897 Issued in WA
Legal business name
JOHN P. HACKETT, MD, P.S.
Practice address
1603 116TH Ave NE
Ste 112
Bellevue, WA 98004-3009
Phone
(425) 456-0709
Fax
(425) 456-0358
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Dr. John P. Hackett, MD
Title
President
Phone
(425) 456-0709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD00013897 WA Primary

Addresses

Primary practice location

1603 116TH Ave NE
Ste 112
Bellevue, WA 98004-3009

Mailing address

1603 116TH Ave NE
Ste 112
Bellevue, WA 98004-3009
Phone (425) 456-0709

National Provider Directory

National Provider Directory

Locations

1603 116th Ave NE
Ste 112
Bellevue, WA 98004
Phone (425) 456-0709

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1346412905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 116TH AVE NE",
            "address_2": "STE 112",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043009",
            "telephone_number": "425-456-0709",
            "fax_number": "425-456-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 116TH AVE NE",
            "address_2": "STE 112",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043009",
            "telephone_number": "425-456-0709",
            "fax_number": "425-456-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P. HACKETT, MD, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "HACKETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-456-0709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00013897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

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