NPIMap

Organization Active NPI

Public Hospital Dist No 1 Skagit

Doing business as Skagit Regional Clinics

  • Surgery Physician
  • Mount Vernon, WA
National Provider Identifier
1639109283
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD00046139 Issued in WA
Legal business name
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Doing business as
Skagit Regional Clinics
Practice address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone
(360) 428-2500
NPI assigned
Jul 3, 2006
Last updated
Nov 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Authorized official

Name
Janis Backstrom, CPMSM
Title
Credentialing Coordinator
Phone
(360) 814-6724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD00046139 WA Primary

Addresses

Primary practice location

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Mailing address

1990 Hospital Dr
Suite 200
Sedro Woolley, WA 98284-9315
Phone (360) 856-4222

Other names 1

  • Skagit Regional Clinics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Skagit Valley Hospital26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1639109283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982849315",
            "telephone_number": "360-856-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "BACKSTROM",
        "authorized_official_first_name": "JANIS",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "360-814-6724",
        "authorized_official_credential": "CPMSM"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00046139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skagit Regional Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.