Individual provider Active NPI

James M Squire, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1649326869
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M000018087 Issued in WA
Practice address
5343 Tallman Ave NW
Suite 203
Seattle, WA 98107-3931
Phone
(206) 789-5555
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M000018087 WA Primary

Addresses

Primary practice location

5343 Tallman Ave NW
Suite 203
Seattle, WA 98107-3931

Mailing address

5343 Tallman Ave NW
Suite 203
Seattle, WA 98107-3931
Phone (206) 789-5555

Other identifiers 3

IdentifierTypeStateIssuer
0075142OtherLABOR & INDUSTRIES
1049717MedicaidWA
S693OtherREGENCE

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
M000018087WAMDFamily Medicine Physician
25209WAMDNuclear Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1649326869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5343 TALLMAN AVE NW",
            "address_2": "SUITE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073931",
            "telephone_number": "206-789-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5343 TALLMAN AVE NW",
            "address_2": "SUITE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073931",
            "telephone_number": "206-789-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "M000018087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0075142",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1049717",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "S693",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.