NPIMap

Individual provider Active NPI

Judith O Son, MD

  • Internal Medicine Physician
  • Olympia, WA
National Provider Identifier
1518012632
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 00034244 Issued in WA
Practice address
404 Black Hills LN SW Ste D
Olympia, WA 98502-8148
Phone
(360) 528-2100
Fax
(360) 528-2104
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 00034244 WA Primary

Addresses

Primary practice location

404 Black Hills LN SW Ste D
Olympia, WA 98502-8148

Mailing address

PO Box 12389
Olympia, WA 98508-2389
Phone (360) 528-2100

Other identifiers 4

IdentifierTypeStateIssuer
1025053MedicaidWA
107850OtherWAREGENCE
110211856OtherWARAILROAD MEDICARE
136113OtherWALABOR & INDUSTRIES

Other names 1

  • Judith R Ogan Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000908 WA Practitioner - Internal Medicine 7810961901 Reassigns benefits to 1 organization
Practice locations: Olympia, WA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

404 Black Hills Lane SW D
Olympia, WA 98502-8148
Phone (360) 528-2100

404 Black Hills LN SW D
Olympia, WA 98502-8148

914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 736-2803

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 00034244WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Dec 1, 2016 Accepting new patients
Grays Harbor County Public Hospital District No 1 Current Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Shane R. Son, MD, PLLC PastSince Aug 1, 2007 Accepting new patients

Locations

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

2026 Olympic Hwy N
Ste 202
Shelton, WA 98584
Phone (206) 426-4390

Interoperability endpoints

  • Direct secure messaging: judith.son.1@16944.direct.athenahealth.com
  • Direct secure messaging: json002@direct.sp-mc.org

Organizations & group practices 4

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 9

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1518012632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12389",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985082389",
            "telephone_number": "360-528-2100",
            "fax_number": "360-528-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 BLACK HILLS LN SW STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028148",
            "telephone_number": "360-528-2100",
            "fax_number": "360-528-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "JUDITH",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD 00034244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025053",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "107850",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110211856",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "136113",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "OGAN",
            "middle_name": "R",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.