Organization Active NPI

Mount Vernon Womens Clinc Inc PS

  • Obstetrics & Gynecology Physician
  • Mount Vernon, WA
National Provider Identifier
1487872388
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MOUNT VERNON WOMENS CLINC INC PS
Practice address
111 N. 17TH Street
Mount Vernon, WA 98273
Phone
(360) 424-4627
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Sara C Rowland, M.D.
Title
President
Phone
(360) 424-4627

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

111 N. 17TH Street
Mount Vernon, WA 98273

Mailing address

111 N. 17TH Street
Mount Vernon, WA 98273
Phone (360) 424-4627

Other identifiers 3

IdentifierTypeStateIssuer
2841OtherPREMERA
S75822OtherREGENCE
7244908MedicaidWA

National Provider Directory

National Provider Directory

Locations

111 N 17th St
Mount Vernon, WA 98273
Phone (360) 424-4627

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1487872388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N. 17TH STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-424-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N. 17TH STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-424-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON WOMENS CLINC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-424-4627",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "2841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "S75822",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7244908",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.