Active NPI
Joseph Prentice, MD
- Anesthesiology Physician
- Centralia, WA
National Provider Identifier
1538221635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD00018900
- Practice address
- 914 S Scheuber Rd
Centralia, WA 98531-9027 - Phone
- (360) 736-2803
- NPI assigned
- Dec 14, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD00018900 | WA | Primary |
Addresses
Primary practice location
914 S Scheuber Rd
Centralia, WA 98531-9027
Mailing address
2940 W Marine View Dr
Everett, WA 98201-3926
Phone (425) 258-7014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1784107 | Medicaid | WA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00018900 | WA | MD | Anesthesiology Physician |
| 025209 | WA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Washington Anesthesia PS | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Centralia, WA
- NPI 1154459550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538221635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 W MARINE VIEW DR",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013926",
"telephone_number": "425-258-7014",
"fax_number": "425-258-7760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 S SCHEUBER RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985319027",
"telephone_number": "360-736-2803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENTICE",
"first_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD00018900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1784107",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.