Gig Harbor Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GIG HARBOR PRIMARY CARE LLC

Practice address

4423 Point Fosdick Dr NW
Suite 306
Gig Harbor, WA 98335-1797

Phone

(253) 432-4437

Fax

(866) 336-4138

NPI assigned

May 19, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Jessica Hopkins

Title

Director of Clinical Operations

Phone

(253) 432-4437

Specialties & licenses 1

Addresses

Other names 1

• Rainier Family Medicine Former legal business name

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

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 4

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

• Scot Darrell Fleshman, MSN, FNP-BC

  • Family Nurse Practitioner
  • Gig Harbor, WA
  • NPI 1295163483
  Medicare reassignment NPD
• Kimberly Dawn Nishina, ARNP

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1275381626

  WA

  Medicare reassignment NPD
• Carole Ann Demarco, PHD

  • Psychologist
  • Gig Harbor, WA
  • NPI 1649254061
  NPD (past)
• Bruce Dykeman, PH.D.

  • Clinical Psychologist
  • Gig Harbor, WA
  • NPI 1265632244
  NPD (past)

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1447607478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 POINT FOSDICK DR NW",
            "address_2": "SUITE 306",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351797",
            "telephone_number": "253-432-4437",
            "fax_number": "866-336-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 POINT FOSDICK DR NW",
            "address_2": "SUITE 306",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351797",
            "telephone_number": "253-432-4437",
            "fax_number": "866-336-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIG HARBOR PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "253-432-4437",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rainier Family Medicine",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gig Harbor Medical Supplies
• Gig Harbor Midwifery, PLLC
• Gig Harbor Naturopathic Medicine PS
• Gig Harbor Operations, LLC
• Gig Harbor Pediatric Occupational Therapy LLC
• Gig Harbor SNF Operations LLC
• Gig Harbor Ventures, L.L.C.
• Gig Harbor Vision Center PS
• Gig Harbor Wellness, PS
• Benjamin Troy Gilkison, DPT

• Primary Care Clinic/Center in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.