Individual provider Active NPI

David Patrick Soha

  • Family Medicine Physician
  • Shelton, WA
National Provider Identifier
1508422767
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61296297 Issued in WA
Practice address
1701 N 13TH St
Shelton, WA 98584-2077
Phone
(360) 426-2653
Fax
(888) 985-0681
NPI assigned
May 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58031022 OH
Family Medicine Physician 207Q00000X OP61296297 WA Primary

Addresses

Primary practice location

1701 N 13TH St
Shelton, WA 98584-2077

Mailing address

PO Box 1668
Shelton, WA 98584-5001
Phone (360) 426-2653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004002544 WA Practitioner - Family Practice 4486989795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital District No 1 of Mason CountyGroup PAC ID 0345139275, 60 clinicians

Practice addresses (Care Compare)

1701 N 13TH St
Shelton, WA 98584-2077
Phone (360) 426-2653

Hospital & facility affiliations

  • Providence at Home With Compassus, Puget Sound South Home health agency, Lacey, WA, CCN 507004
  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58031022OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County Wa CurrentSince Sep 26, 2022 Accepting new patients
Public Hospital District No 1 of Mason County Current Accepting new patients
Public Hospital District No 1 of Mason County CurrentSince Sep 26, 2022 Accepting new patients

Locations

1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1508422767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1668",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985845001",
            "telephone_number": "360-426-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653",
            "fax_number": "888-985-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHA",
        "first_name": "DAVID",
        "middle_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58031022",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61296297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.