Organization Active NPI

Franciscan Medical Group

Doing business as FMG-Franciscan Medical Clinic - Spanaway

  • Family Medicine Physician
  • Spanaway, WA
National Provider Identifier
1366732190
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
FMG-Franciscan Medical Clinic - Spanaway
Practice address
144 169TH St S
Ste a
Spanaway, WA 98387-8201
Phone
(253) 536-2824
Fax
(253) 536-3070
NPI assigned
Apr 13, 2011
Last updated
Apr 13, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Authorized official

Name
Dean Field, MDNPI 1710901400
Title
Chief Medical Officer
Phone
(253) 858-9192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

144 169TH St S
Ste a
Spanaway, WA 98387-8201

Mailing address

PO Box 31001-1518
Pasadena, CA 91110-1518
Phone (253) 552-4100

Other names 1

  • FMG-Franciscan Medical Clinic - Spanaway Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
CHI Franciscan Health

Locations

144 169th St S
Ste A
Spanaway, WA 98387
Phone (253) 536-2824

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1366732190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-1518",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911101518",
            "telephone_number": "253-552-4100",
            "fax_number": "253-552-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 169TH ST S",
            "address_2": "STE A",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878201",
            "telephone_number": "253-536-2824",
            "fax_number": "253-536-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "253-858-9192",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMG-Franciscan Medical Clinic - Spanaway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spanaway, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.