Individual provider Active NPI

Sara J Murdoch, M.D.

  • Pediatrics Physician
  • Olympia, WA
National Provider Identifier
1609961481
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD0029173 Issued in WA
Practice address
3516 12TH Ave NE
Olympia, WA 98506-5218
Phone
(360) 918-0604
Fax
(360) 456-6504
NPI assigned
Oct 4, 2006
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD0029173 WA Primary

Addresses

Primary practice location

3516 12TH Ave NE
Olympia, WA 98506-5218

Mailing address

3516 12TH Ave NE
Olympia, WA 98506-5218
Phone (360) 918-0604

Other identifiers 1

IdentifierTypeStateIssuer
1014528MedicaidWA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0029173WAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1609961481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-918-0604",
            "fax_number": "360-456-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-918-0604",
            "fax_number": "360-456-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCH",
        "first_name": "SARA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD0029173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014528",
            "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 Apr 21, 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.

Verify at the official NPI Registry.