Franciscan Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FRANCISCAN MEDICAL GROUP

Practice address

7210 40TH St W
Ste 100
University Place, WA 98466-4318

Phone

(253) 564-0170

NPI assigned

Jul 3, 2006

Organization subpart

Yes

Parent organization

FRANCISCAN MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Cliff A Robertson, MD

Title

Chief Medical Officer

Phone

(253) 779-6101

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• University Place Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Part of

Enumclaw Medical Center

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1376572065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664318",
            "telephone_number": "253-564-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664318",
            "telephone_number": "253-564-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2006-07-03",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "253-779-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7095151",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7129539",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0126534",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Place Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aleah Fox
• Carrie Scholastica Fraga
• Franciscan City Urgent Care Services, PS
• Franciscan Health System
• Franciscan Health System
• Franciscan Medical Group
• Lisa Frank, RPH
• Nikki Jane Frantz, LMT
• Fred Meyer Stores Inc
• Sharon Kay Frederick, RN

• All providers in University Place, WA
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.