Organization Active NPI

Franciscan Medical Group

  • Rheumatology Physician
  • Gig Harbor, WA
National Provider Identifier
1740238500
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
ROAD Clinic
Practice address
4700 Point Fosdick Dr NW
#111
Gig Harbor, WA 98335-1706
Phone
(253) 961-2187
Fax
(253) 858-5059
NPI assigned
May 4, 2006
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Authorized official

Name
Dr. Cliff A. Robertson, MD
Title
Chief Medical Officer
Phone
(253) 779-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

4700 Point Fosdick Dr NW
#111
Gig Harbor, WA 98335-1706

Mailing address

4700 Point Fosdick Dr NW
#111
Gig Harbor, WA 98335-1706
Phone (253) 961-2187

Other identifiers 1

IdentifierTypeStateIssuer
7133234MedicaidWA

Other names 1

  • ROAD Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Enumclaw Medical Center

Practitioners & affiliated clinicians

Practitioners 2

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1740238500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "#111",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-961-2187",
            "fax_number": "253-858-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "#111",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-961-2187",
            "fax_number": "253-858-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "253-779-6101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7133234",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROAD Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.