Edmonds Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EDMONDS MEDICAL CLINIC INC

Practice address

21600 Highway 99 Ste 280
Edmonds, WA 98026-8022

Phone

(360) 901-6355

NPI assigned

Feb 1, 2020

Organization subpart

No

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

Authorized official

Name

Steven KohNPI 1114114535

Title

President

Phone

(425) 582-7753

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Koh, MD

  • Family Medicine Physician
  • Edmonds, WA
  • NPI 1114114535

  Chiropractor

  Medicare reassignment Care Compare group NPD Authorized official
• Yoon Jin Park, M.D.

  • Family Medicine Physician
  • Edmonds, WA
  • NPI 1801020946
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1580515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596240000000",
    "number": "1376174979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99 STE 280",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268022",
            "telephone_number": "425-582-7753",
            "fax_number": "425-740-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99 STE 280",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268022",
            "telephone_number": "360-901-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDS MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-01",
        "last_updated": "2020-08-01",
        "certification_date": "2020-08-01",
        "status": "A",
        "authorized_official_last_name": "KOH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-582-7753"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmonds Eyecare Associates Inc PS
• Edmonds Family Chiropractic LLC
• Edmonds Family Medicine Clinic PS
• Edmonds Garden Afh LLC
• Edmonds Health Clinic
• Edmonds Oral & Facial Surgery
• Edmonds Oral Surgery, P.S.
• Edmonds Physical Therapy & Sports Rehab
• Edmonds Psychological and Pastoral Care
• Edmonds Rheumatology Associates Incorporated

• Family Medicine Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.