NPIMap

Organization Active NPI

Sumas Clinic, Inc. P.S.

  • Family Medicine Physician
  • Sumas, WA
National Provider Identifier
1508056052
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00039892 Issued in WA
Legal business name
SUMAS CLINIC, INC. P.S.
Practice address
112 Columbia St.
Sumas, WA 98295-1010
Phone
(360) 988-9404
Fax
(360) 988-9409
NPI assigned
Jul 31, 2007
Last updated
Jul 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Dr. Rodney Lee Brian Thompson, M.D.NPI 1255393450
Title
Physician/President
Phone
(360) 988-9404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00039892 WA Primary

Addresses

Primary practice location

112 Columbia St.
Sumas, WA 98295-1010

Mailing address

PO Box 1010
112 Columbia St.
Sumas, WA 98295-1010
Phone (360) 988-9404

Other identifiers 2

IdentifierTypeStateIssuer
8294498MedicaidWA
7127285MedicaidWA

Other names 1

  • DBA Sumas Medical Clinic, Sumas Clinic Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1508056052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1010",
            "address_2": "112 COLUMBIA ST.",
            "city": "SUMAS",
            "state": "WA",
            "postal_code": "982951010",
            "telephone_number": "360-988-9404",
            "fax_number": "360-988-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 COLUMBIA ST.",
            "city": "SUMAS",
            "state": "WA",
            "postal_code": "982951010",
            "telephone_number": "360-988-9404",
            "fax_number": "360-988-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMAS CLINIC, INC. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "LEE BRIAN",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "360-988-9404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8294498",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7127285",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Sumas Medical Clinic, Sumas Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sumas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.