Organization Active NPI

Franciscan Medical Group

Doing business as FMG-Endocrine Consultants Northwest

  • Endocrinology, Diabetes & Metabolism Physician
  • Tacoma, WA
National Provider Identifier
1588998546
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
FMG-Endocrine Consultants Northwest
Practice address
1628 S Mildred St
#104
Tacoma, WA 98465-1627
Phone
(253) 565-6777
Fax
(253) 565-8777
NPI assigned
Sep 23, 2009
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Dean A. Field, MD
Title
Chief Medical Officer
Phone
(253) 680-4009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X WA Primary

Addresses

Primary practice location

1628 S Mildred St
#104
Tacoma, WA 98465-1627

Mailing address

1628 S Mildred St
#104
Tacoma, WA 98465-1627
Phone (253) 565-6777

Other names 1

  • FMG-Endocrine Consultants Northwest Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Enumclaw Medical Center

Locations

1628 S Mildred St
Ste 104
Tacoma, WA 98465
Phone (253) 565-6777

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1588998546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 S MILDRED ST",
            "address_2": "#104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651627",
            "telephone_number": "253-565-6777",
            "fax_number": "253-565-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 S MILDRED ST",
            "address_2": "#104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651627",
            "telephone_number": "253-565-6777",
            "fax_number": "253-565-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "253-680-4009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMG-Endocrine Consultants Northwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.