NPIMap

Organization Active NPI

Franciscan Health System

Doing business as Franciscan Spine Center (Tac)

  • Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1639318462
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
FRANCISCAN HEALTH SYSTEM
Doing business as
Franciscan Spine Center (Tac)
Practice address
1624 S I St
Ste 303
Tacoma, WA 98405-5016
Phone
(253) 426-4603
Fax
(253) 426-4601
NPI assigned
Feb 18, 2009
Last updated
Oct 27, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Authorized official

Name
Mike Fitzgerald
Title
VP Finance
Phone
(253) 680-4005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

1624 S I St
Ste 303
Tacoma, WA 98405-5016

Mailing address

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-4603

Other identifiers 1

IdentifierTypeStateIssuer
7146285MedicaidWA

Other names 1

  • Franciscan Spine Center (Tac) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000147 WA Part B Supplier - Clinic/Group Practice 1557254935 Receives reassigned benefits from 27 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, WA; University Place, WA; Silverdale, WA; Puyallup, WA; Lakewood, WA; Gig Harbor, WA

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Part of
St Joseph Hospital Lab

Locations

1624 S I St
Ste 303
Tacoma, WA 98405
Phone (253) 272-1231

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1639318462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-4603",
            "fax_number": "253-426-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 S I ST",
            "address_2": "STE 303",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055016",
            "telephone_number": "253-426-4603",
            "fax_number": "253-426-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN HEALTH SYSTEM",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "253-680-4005"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7146285",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franciscan Spine Center (Tac)",
            "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 Oct 27, 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.