Active NPI
Philip Roy Halvorsen, M.D.
- Maternal & Fetal Medicine Physician
- Richland, WA
National Provider Identifier
1568474377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- MD00025724
- Practice address
- 969 Stevens Dr
Suite 3a
Richland, WA 99352-3525 - Phone
- (509) 946-8696
- Fax
- (509) 946-8646
- NPI assigned
- Aug 12, 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 |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | MD00025724 | WA | Primary |
Addresses
Primary practice location
969 Stevens Dr
Suite 3a
Richland, WA 99352-3525
Mailing address
560 Gage Blvd
Suite 203
Richland, WA 99352-3525
Phone (509) 942-3627
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013452 | Medicaid | WA | |
| 1568474377 | Other | WA | NPI |
| 1120732 | 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 |
|---|---|---|---|
| MD00025724 | WA | MD | Maternal & Fetal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kadlec Regional Medical Center | 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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1568474377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 GAGE BLVD",
"address_2": "SUITE 203",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523525",
"telephone_number": "509-942-3627",
"fax_number": "509-942-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "969 STEVENS DR",
"address_2": "SUITE 3A",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523525",
"telephone_number": "509-946-8696",
"fax_number": "509-946-8646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVORSEN",
"first_name": "PHILIP",
"middle_name": "ROY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "WA",
"license": "MD00025724",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013452",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1568474377",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1120732",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richland, 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.