Northwest Cardiovascular

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

NORTHWEST CARDIOVASCULAR

Practice address

1812 S J St
Suite 210
Tacoma, WA 98405-4964

Phone

(253) 572-8777

Fax

(253) 572-8835

NPI assigned

Mar 22, 2007

Last updated

Dec 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Glenda Lee Medeen

Title

Business Manager

Phone

(253) 572-8777

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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.

• Daniel Brocksmith, PA-C

  • Surgical Physician Assistant
  • Tacoma, WA
  • NPI 1114942554
  NPD (past)
• John Michael Luber Jr., MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tacoma, WA
  • NPI 1801821756
  NPD (past)
• Jerry J Papson, PA-C

  • Surgical Physician Assistant
  • Tacoma, WA
  • NPI 1396763140
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1700902368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "SUITE 210",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-572-8777",
            "fax_number": "253-572-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "SUITE 210",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-572-8777",
            "fax_number": "253-572-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CARDIOVASCULAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "MEDEEN",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "253-572-8777",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7129372",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corrie Northfell, ARNP
• Northland Hearing Center, Inc. (A-Plus Hearing Aid Tacoma)
• Northland Hearing Center, Inc. (A-Plus Hearing Aid Centers)
• Northland Hearing Centers, Inc. (All-American Hearing)
• Reve K Northrup, CNA/CMA
• Northwest Center for Integrative Medicine
• Northwest Center for Sports Medicine & Physical Therapy, Inc. (Northwest Sports Physical Therapy, Inc.)
• Northwest Evaluation and Consultation Services Incorporated
• Northwest Family & Spinal Clinic Inc PS
• Northwest Ketamine Clinics Tacoma, PLLC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.