Bellingham Medical Clinic Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00039703 Issued in WA

Legal business name

BELLINGHAM MEDICAL CLINIC INC

Practice address

4204 Meridian St, Ste 105
Bellingham, WA 98226

Phone

(360) 715-9500

Fax

(360) 752-1407

NPI assigned

Nov 23, 2007

Reactivated

Mar 21, 2011

Organization subpart

No

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

Authorized official

Name

Joy E Krumdiack

Title

Office Manager

Phone

(360) 715-9500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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

• Gittle G Goodman Wilson, MD

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1811034234
  Medicare reassignment
• Mani N. Sury, M.D.

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1922008382

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1457532004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 MERIDIAN ST, STE 105",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-715-9500",
            "fax_number": "360-752-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 MERIDIAN ST, STE 105",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-715-9500",
            "fax_number": "360-752-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLINGHAM MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2011-03-25",
        "deactivation_date": "2011-02-22",
        "reactivation_date": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "KRUMDIACK",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-715-9500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00039703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bellingham Healing Center
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• Bellingham Internal Medicine Associates, PC
• Bellingham Massage Works
• Bellingham Medical Massage
• Bellingham Natural Family Medicine
• Bellingham North of Cascadia, LLC
• Bellingham Obstetrics & Gynecologic Associates
• Bellingham of Olympus, LLC

• Internal Medicine Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.