Rainier Family and Sports Medicine P C

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

RAINIER FAMILY AND SPORTS MEDICINE P C

Practice address

16202 64TH St E Ste 104
Sumner, WA 98390-3028

Phone

(253) 987-7754

Fax

(253) 987-7049

NPI assigned

Jun 23, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kent R Walker, DO

Title

Ceo/President

Phone

(253) 987-7754

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21159/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1588280804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 LAKE TAPPS PKWY SE",
            "address_2": "STE F104 #133",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "98390",
            "telephone_number": "253-987-7754",
            "fax_number": "253-987-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16202 64TH ST E STE 104",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983903028",
            "telephone_number": "253-987-7754",
            "fax_number": "253-987-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINIER FAMILY AND SPORTS MEDICINE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "253-987-7754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "833-989-2308",
            "affiliation": "N",
            "endpointDescription": "secure EMR fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "16202 64th St E Ste 104",
            "city": "Sumner",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983903028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Sumner, WA
• Providers in Sumner, WA by specialty
• Sports Medicine (Family Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.