Individual provider Active NPI

Scott Hulse

  • Clinical Informatics Physician
  • Tacoma, WA
National Provider Identifier
1649651415
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Informatics PhysicianTaxonomy code 2083C0008X
License
DR.0057754 Issued in CO
Practice address
9040 Jackson Ave
Tacoma, WA 98431-5638
Phone
(253) 968-2252
NPI assigned
Jun 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Informatics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083C0008X DR.0057754 CO Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Other practice location 1

101 Bodin Circle
Travis AFB, CA 94535-1800
Phone (707) 816-5690

Other practice location 2

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 652-7473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1649651415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984315638",
            "telephone_number": "253-968-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Bodin Circle",
            "address_purpose": "LOCATION",
            "city": "Travis AFB",
            "state": "CA",
            "postal_code": "945351800",
            "country_code": "US",
            "telephone_number": "707-816-5690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-652-7473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULSE",
        "first_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "CO",
            "license": "DR.0057754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.