The Doctors Clinic a Professional Corporation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

THE DOCTORS CLINIC A PROFESSIONAL CORPORATION

Doing business as

The Doctors Clinic Salmon Medical Center

Practice address

2200 NW Myhre Rd
Silverdale, WA 98383-7681

Phone

(360) 830-1100

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Jay Burghart

Title

Executive Director

Phone

(360) 782-3600

Specialties & licenses 3

Addresses

Other identifiers 7

Other names 1

• THE DOCTORS CLINIC SALMON MEDICAL CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

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

• Brian Kap-Soo Kim, M.D.

  • Hematology & Oncology Physician
  • Sacramento, CA
  • NPI 1871532051

  I20110718000370, I20250417001617

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Kap-Soo Kim, M.D.

  • Hematology & Oncology Physician
  • Sacramento, CA
  • NPI 1871532051
  NPD

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1700833357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837681",
            "telephone_number": "360-830-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTORS CLINIC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "BURGHART",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-782-3600"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS COMP",
            "identifier": "8903693",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY P.T.",
            "identifier": "7127822",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7126790",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11945",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "75420",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CU0247",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "337018607",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE DOCTORS CLINIC SALMON MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE DOCTORS CLINIC SALMON MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Multi-Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.