Individual provider Active NPI

John Raymond Avant Storey, MD

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1518372416
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61108167 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 304-8431
NPI assigned
Jun 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.MD.6108167 WA
Emergency Medicine Physician 207P00000X A150375 CA
Emergency Medicine Physician 207P00000X MD61108167 WA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD61108167 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 304-8431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201124002244 WA Practitioner - Emergency Medicine 7113359563 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A150375CAMDEmergency Medicine Physician
MD.MD.6108167WAMDEmergency Medicine Physician
MD61108167WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Feb 15, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 9, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Sep 9, 2022 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Northwest Observation Associates PC CurrentSince Feb 15, 2022 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients

Locations

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2930 Maple St
Everett, WA 98201
Phone (425) 261-1500

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1518372416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-304-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOREY",
        "first_name": "JOHN RAYMOND",
        "middle_name": "AVANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD.MD.6108167",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A150375",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61108167",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61108167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.