Individual provider Active NPI

John Edward Midtling, MD

  • Family Medicine Physician
  • Redmond, WA
National Provider Identifier
1720024490
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60139996 Issued in WA
Practice address
8299 161St Ave NE
#101
Redmond, WA 98052-3860
Phone
(425) 881-8813
Fax
(425) 869-7201
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37234 TN
Family Medicine Physician 207Q00000X MD60139996 WA Primary

Addresses

Primary practice location

8299 161St Ave NE
#101
Redmond, WA 98052-3860

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3292

Other identifiers 8

IdentifierTypeStateIssuer
38128OtherTNTLC
626001636OtherTNUNITED HEALTHCARE
626001636OtherTNUSA MANAGED CARE
626001636OtherTNHEALTH PARTNERS
3818686MedicaidTN
4135399OtherTNBLUE CROSS BLUE SHIELD
190944OtherTNUNISON
2504635OtherTNCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60139996WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Family Medicine Past Accepting new patients
Santa Cruz Medical Clinic, Inc Family Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1720024490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3292",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8299 161ST AVE NE",
            "address_2": "#101",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523860",
            "telephone_number": "425-881-8813",
            "fax_number": "425-869-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDTLING",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "37234",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60139996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "38128",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "626001636",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "626001636",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "626001636",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3818686",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4135399",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "190944",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2504635",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.