Individual provider Active NPI

Connor Houghton, D.O.

  • Emergency Medicine Physician
  • Lakewood, WA
National Provider Identifier
1437681343
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
61020108 Issued in WA
Practice address
11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone
(253) 985-1711
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 61020108 WA Primary

Addresses

Primary practice location

11315 Bridgeport Way SW
Lakewood, WA 98499-3004

Mailing address

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 985-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721000555 WA Practitioner - Emergency Medicine 8921373283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New England, College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 588-1711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61020108WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Single Specialty CurrentSince Jul 1, 2020 Accepting new patients
Northwest Observation Associates PC Single Specialty CurrentSince Jul 1, 2020 Accepting new patients

Locations

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1437681343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993004",
            "telephone_number": "253-985-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993004",
            "telephone_number": "253-985-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTON",
        "first_name": "CONNOR",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "61020108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.