Active NPI
Scott J Tibbits, MD
- Internal Medicine Physician
- Olympia, WA
National Provider Identifier
1538220132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00030644
- Practice address
- 3425 Ensign Rd NE
Suite 220
Olympia, WA 98506-5425 - Phone
- (360) 491-1112
- Fax
- (360) 493-8160
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00030644 | WA | Primary |
Addresses
Primary practice location
3425 Ensign Rd NE
Suite 220
Olympia, WA 98506-5425
Mailing address
PO Box 3360
Suite 220
Portland, OR 97208-3360
Phone (360) 493-4069
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 539787389 | Other | WA | CIGNA HEALTH INSURANCE |
| 8148694 | Medicaid | WA | |
| 0149441 | Other | WA | LABOR & INDUSTRIES |
| 110221313 | Other | WA | RAILROAD MEDICARE |
| 3911TI | Other | WA | COUNTY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1538220132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"address_2": "SUITE 220",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360",
"telephone_number": "360-493-4069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3425 ENSIGN RD NE",
"address_2": "SUITE 220",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065425",
"telephone_number": "360-491-1112",
"fax_number": "360-493-8160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBITS",
"first_name": "SCOTT",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00030644",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH INSURANCE",
"identifier": "539787389",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8148694",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0149441",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110221313",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNTY",
"identifier": "3911TI",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.