The Doctors Clinic a Professional Corporation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

THE DOCTORS CLINIC A PROFESSIONAL CORPORATION

Practice address

450 S Kitsap Blvd
BLDG. 1, Suite 250
Port Orchard, WA 98366-3773

Phone

(360) 782-3000

Fax

(360) 782-3040

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Jay Burghart

Title

Executive Director

Phone

(360) 782-3600

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 2

• THE DOCTORS CLINIC OF PORT ORCHARD Doing business as
• The Doctors Clinic a part of Franciscan Medical Group Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1396793709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD",
            "address_2": "BLDG. 1, SUITE 250",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663773",
            "telephone_number": "360-782-3000",
            "fax_number": "360-782-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTORS CLINIC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "BURGHART",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-782-3600"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "337018600",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CU0247",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7053895",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "50D0635293",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS COMPENSATIO",
            "identifier": "8919256",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE DOCTORS CLINIC OF PORT ORCHARD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Doctors Clinic a part of Franciscan Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dee Ann Hackett Taylor, MD
• Andrew J Tellington, D.M.D
• Leslie Tercero
• Kayla M Terry
• Jennifer Thatcher, PTA
• The Personal Touch, LLC
• The Pesonal Touch, LLC
• Desmond Emery Thomas
• Kathleen G. Thomas, P.A.
• Melanie Thomas

• Multi-Specialty Clinic/Center in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Multi-Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.