NPIMap

Organization Active NPI

Cep America LLC

  • Emergency Medicine Physician
  • Edmonds, WA
National Provider Identifier
1447484274
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CEP AMERICA LLC
Practice address
21601 76TH Ave W
Edmonds, WA 98026-7507
Phone
(425) 640-4000
Fax
(425) 640-4024
NPI assigned
May 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
David Birdsall, M.D.
Title
Coo
Phone
(510) 350-2600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

21601 76TH Ave W
Edmonds, WA 98026-7507

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 350-2600

Other names 1

  • Vituity Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130213000571 WA Part B Supplier - Clinic/Group Practice 6608056171 Receives reassigned benefits from 162 practitioners
2 other NPIs on this enrollment
Practice locations: Edmonds, WA; Friday Harbor, WA; Longview, WA

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

Practitioners & affiliated clinicians

Practitioners 277

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

View all 277

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1447484274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21601 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267507",
            "telephone_number": "425-640-4000",
            "fax_number": "425-640-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-07",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "BIRDSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vituity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.