NPIMap

Organization Active NPI

Village Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Issaquah, WA
National Provider Identifier
1720426372
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
AP60081924 Issued in WA
Legal business name
VILLAGE PEDIATRICS, PLLC
Practice address
317 NW Gilman Blvd Ste 48
Issaquah, WA 98027-2485
Phone
(425) 996-3396
Fax
(425) 996-0231
NPI assigned
Jun 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Staci Scott, ARNPNPI 1285818369
Title
Pediatric Nurse Practitioner
Phone
(814) 387-8224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X AP60081924 WA Primary

Addresses

Primary practice location

317 NW Gilman Blvd Ste 48
Issaquah, WA 98027-2485

Mailing address

1975 25TH Ave NE
Issaquah, WA 98029-7737
Phone (814) 387-8224

National Provider Directory

National Provider Directory

Locations

317 NW Gilman Blvd
Ste 48
Issaquah, WA 98027
Phone (425) 996-3396

450 NW Gilman Blvd
Issaquah, WA 98027
Phone (206) 392-0627

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1720426372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 25TH AVE NE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297737",
            "telephone_number": "814-387-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 NW GILMAN BLVD STE 48",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272485",
            "telephone_number": "425-996-3396",
            "fax_number": "425-996-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "PEDIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "814-387-8224",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "AP60081924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.