Organization Active NPI

Peacehealth

Doing business as St Joseph Medical Center

  • Multi-Specialty Clinic/Center
  • Bellingham, WA
National Provider Identifier
1457553497
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PEACEHEALTH
Doing business as
St Joseph Medical Center
Practice address
2901 Squalicum Parkway
Bellingham, WA 98225
Phone
(360) 734-5400
Fax
(360) 756-3552
NPI assigned
Jun 1, 2007
Last updated
Feb 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
Dale J Zender
Title
Cfo
Phone
(360) 788-6797

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X
Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0005X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Multi-Specialty Clinic/Center 261QM1300X WA Primary

Addresses

Primary practice location

2901 Squalicum Parkway
Bellingham, WA 98225

Mailing address

2901 Squalicum Parkway
Bellingham, WA 98225
Phone (360) 734-5400

Other names 1

  • St Joseph Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118001062 WA Part B Supplier - Clinic/Group Practice 9537073960 Receives reassigned benefits from 452 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellingham, WA; Lynden, WA; Burlington, WA; Anacortes, WA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

2800 Douglas Ave
Bellingham, WA 98225
Phone (360) 733-5877

2979 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 788-6800

3015 Squalicum Pkwy
Ste 210
Bellingham, WA 98225
Phone (360) 738-9570

3125 Old Fairhaven Pkwy
Ste 10
Bellingham, WA 98225

4465 Cordata Pkwy
Ste 102
Bellingham, WA 98226
Phone (360) 752-5280

4465 Cordata Pkwy
Ste C
Bellingham, WA 98226
Phone (360) 752-5280

4545 Cordata Pkwy
Ste 1
Bellingham, WA 98226

4545 Cordata Pkwy
Ste 1B
Bellingham, WA 98226
Phone (360) 752-5216

4545 Cordata Pkwy
Ste 1F
Bellingham, WA 98226
Phone (360) 752-5246

4545 Cordata Pkwy
Ste 2B
Bellingham, WA 98226
Phone (360) 752-5220

4545 Cordata Pkwy
Ste 2C
Bellingham, WA 98226
Phone (360) 752-5165

4545 Cordata Pkwy
Ste 2D
Bellingham, WA 98226
Phone (360) 752-5165

800 E Chestnut St
Ste 3E
Bellingham, WA 98225
Phone (360) 715-6565

1610 Grover St
Ste C6
Lynden, WA 98264
Phone (360) 752-5280

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1457553497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SQUALICUM PARKWAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-734-5400",
            "fax_number": "360-756-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SQUALICUM PARKWAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-734-5400",
            "fax_number": "360-756-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "ZENDER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-788-6797"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Joseph Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.