Craig Longridge Southwell, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00026911 Issued in WA

Practice address

942 Cedar Lake CT SE
Olympia, WA 98501-9715

Phone

(360) 481-8186

NPI assigned

Oct 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kittitas County Public Hospital Dist 1

  dba Kittitas Valley Community Hospital

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment NPD
• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940
  Medicare reassignment NPD
• Kittitas County Public Hosp Dist 1

  dba KVH Urology

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  dba KVH Family Medicine Ellensburg

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1770711764
  NPD
• Yakima Valley Memorial Physicians

  • Durable Medical Equipment & Medical Supplies
  • Yakima, WA
  • NPI 1366325870
  NPD
• Pacific Northwest Healthcare

  dba Occupational Medicine Associates of Kitsap

  • Specialist
  • Silverdale, WA
  • NPI 1043260185
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689755787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 CEDAR LAKE CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985019715",
            "telephone_number": "360-481-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 CEDAR LAKE CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985019715",
            "telephone_number": "360-481-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWELL",
        "first_name": "CRAIG",
        "middle_name": "LONGRIDGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00026911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8116519",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Sound Radiologists Inc P S (South Sound Radiology)
• South Sound Surgical Associates
• South Sound Vasectomy and Men's Health
• South Sound Women's Center LLP
• Jakob Larz South
• Gary Daniel Southwell, PH.D.
• Southwestern Washington Urology Clinic PLLC
• Xuan Sowell
• Burton Allan Sowers, DC
• Robyn Morisette Sowers, LMFT

• Emergency Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.