Individual provider Active NPI

Bruce D Romig

  • Obstetrics & Gynecology Physician
  • Puyallup, WA
National Provider Identifier
1457406761
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
14802 Issued in WA
Practice address
520 14TH Ave SE
Puyallup, WA 98372-4683
Phone
(253) 845-1962
Fax
(253) 770-8640
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 14802 WA Primary

Addresses

Primary practice location

520 14TH Ave SE
Puyallup, WA 98372-4683

Mailing address

520 14TH Ave SE
Puyallup, WA 98372-4683
Phone (253) 845-1962

Other identifiers 1

IdentifierTypeStateIssuer
7113608MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14802WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Puyallup Valley Women'S Clinic, Inc.,P.S. Obstetrics & Gynecology CurrentSince Aug 4, 2011 Accepting new patients

Locations

1420 3rd St SE
Ste 202
Puyallup, WA 98372
Phone (253) 256-4818

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457406761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724683",
            "telephone_number": "253-845-1962",
            "fax_number": "253-770-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724683",
            "telephone_number": "253-845-1962",
            "fax_number": "253-770-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMIG",
        "first_name": "BRUCE",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "14802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7113608",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.