Individual provider Active NPI

Clifford Louis Lightfoot III, DO

  • Emergency Medicine Physician
  • Pullman, WA
National Provider Identifier
1700036084
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.009787 Issued in OH
Practice address
835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone
(509) 336-7386
NPI assigned
Sep 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.009787 OH Primary

Addresses

Primary practice location

835 SE Bishop Blvd
Pullman, WA 99163-5512

Mailing address

835 SE Bishop Blvd
Pullman, WA 99163-5512

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111005000776 WA Practitioner - Emergency Medicine 4880880111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital District 1-a of Whitman CountyGroup PAC ID 8325934987, 86 clinicians

Practice addresses (Care Compare)

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 332-2541

Hospital & facility affiliations

  • Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Jul 3, 2011 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients

Locations

825 SE Bishop Blvd
Ste 201
Pullman, WA 99163
Phone (509) 336-7577

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1700036084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-336-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTFOOT",
        "first_name": "CLIFFORD",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-24",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.009787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.