Organization Active NPI

Member Plus Family Health PLLC

  • Family Medicine Physician
  • Bainbridge Island, WA
National Provider Identifier
1447740998
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMBER PLUS FAMILY HEALTH PLLC
Practice address
123 Bjune Dr SE Ste 101
Bainbridge Island, WA 98110-2459
Phone
(206) 842-3222
Fax
(206) 842-1877
NPI assigned
May 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Authorized official

Name
Blain Crandell, M.D.NPI 1215964614
Title
Owner/Provider
Phone
(206) 842-3222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

123 Bjune Dr SE Ste 101
Bainbridge Island, WA 98110-2459

Mailing address

123 Bjune Dr SE Ste 101
Bainbridge Island, WA 98110-2459
Phone (206) 842-3222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200828000493 WA Part B Supplier - Clinic/Group Practice 5597182048 Receives reassigned benefits from 2 practitioners
Practice locations: Bainbridge Island, WA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1014202Member Plus Family Health123 Bjune Dr SE Ste 101, Bainbridge Island, WA 98110Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Locations

123 Bjune Dr SE
Ste 101
Bainbridge Island, WA 98110
Phone (206) 842-3222

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1447740998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BJUNE DR SE STE 101",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102459",
            "telephone_number": "206-842-3222",
            "fax_number": "206-842-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BJUNE DR SE STE 101",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102459",
            "telephone_number": "206-842-3222",
            "fax_number": "206-842-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMBER PLUS FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "CRANDELL",
        "authorized_official_first_name": "BLAIN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "206-842-3222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.