NPIMap

Organization Active NPI

Neighborcare Health

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1679891402
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEIGHBORCARE HEALTH
Practice address
12736 33Rd Ave NE
Suite 200
Seattle, WA 98125-4504
Phone
(206) 367-0135
Fax
(206) 367-0150
NPI assigned
May 4, 2010
Last updated
Jun 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Authorized official

Name
Ms. Amanda L Langan
Title
Provider Enrollment Specialist
Phone
(206) 548-3114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

12736 33Rd Ave NE
Suite 200
Seattle, WA 98125-4504

Mailing address

905 Spruce St Ste 300
Seattle, WA 98104-2474
Phone (206) 367-0135

Other names 1

  • McDermott Place Medical Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000573 WA Part B Supplier - Clinic/Group Practice 0143134205 Receives reassigned benefits from 317 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA; Vashon, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679891402. Details of each certification follow.

  • CCN 501931 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 501931

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MCDERMOTT MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 18, 2011
Last certification
Apr 18, 2011
Ownership / control type
For profit – partnership
Facility address
12736 33Rd Avenue NE
Lake City, WA 98125

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1679891402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SPRUCE ST STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042474",
            "telephone_number": "206-367-0135",
            "fax_number": "206-367-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12736 33RD AVE NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254504",
            "telephone_number": "206-367-0135",
            "fax_number": "206-367-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORCARE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "LANGAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "206-548-3114",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDermott Place Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.