Individual provider Active NPI

Anneliese Herseth Floyd, MD

  • Family Medicine Physician
  • Bellingham, WA
National Provider Identifier
1366645947
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ML20008318 Issued in WA
Practice address
2075 Barkley Blvd
Suite 105
Bellingham, WA 98226-6614
Phone
(360) 671-3345
Fax
(360) 650-1354
NPI assigned
Jun 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00048880 WA
Family Medicine Physician 207Q00000X ML20008318 WA Primary

Addresses

Primary practice location

2075 Barkley Blvd
Suite 105
Bellingham, WA 98226-6614

Mailing address

709 W Orchard Dr
Suite 4
Bellingham, WA 98225-1766
Phone (360) 318-8800

Other identifiers 4

IdentifierTypeStateIssuer
2075FLOtherWAREGENCE
8949110OtherWAL&I CRIME VICTIMS
0241356OtherWAL&I REGULAR
8525735MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00048880WAMDFamily Medicine Physician
ML20008318WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Network PLLC Family Medicine CurrentSince Jan 2, 2009 Accepting new patients
Family Care Network PLLC Family Medicine CurrentSince Jan 2, 2009 Accepting new patients

Locations

2075 Barkley Blvd
Ste 105
Bellingham, WA 98226
Phone (360) 671-3345

1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785

Interoperability endpoints

  • Direct secure messaging: afloyd19553@direct.fcn.net

Organizations & group practices 2

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1366645947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W ORCHARD DR",
            "address_2": "SUITE 4",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251766",
            "telephone_number": "360-318-8800",
            "fax_number": "360-318-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 BARKLEY BLVD",
            "address_2": "SUITE 105",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266614",
            "telephone_number": "360-671-3345",
            "fax_number": "360-650-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "ANNELIESE",
        "middle_name": "HERSETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00048880",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML20008318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2075FL",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8949110",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I REGULAR",
            "identifier": "0241356",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8525735",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.