NPIMap

Organization Active NPI

Internal Medicine Consultants NW PS

  • Internal Medicine Physician
  • La Conner, WA
National Provider Identifier
1497022370
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE CONSULTANTS NW PS
Practice address
456 Klickitat Dr
La Conner, WA 98257-9517
Phone
(360) 466-9223
NPI assigned
Nov 21, 2011
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Nancy Llewellyn, MDNPI 1760576474
Title
Owner
Phone
(360) 466-9223

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

456 Klickitat Dr
La Conner, WA 98257-9517

Mailing address

PO Box 190
La Conner, WA 98257-0190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120202000483 WA Part B Supplier - Clinic/Group Practice 1355508359 Receives reassigned benefits from 7 practitioners
Practice locations: Mount Vernon, WA; Oak Harbor, WA; Anacortes, WA

National Provider Directory

National Provider Directory

Locations

3502 K Ave
Anacortes, WA 98221
Phone (360) 419-6317

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1497022370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982570190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 KLICKITAT DR",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982579517",
            "telephone_number": "360-466-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE CONSULTANTS NW PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "LLEWELLYN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-466-9223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Conner, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.