Organization Active NPI

Shelton Family Medicine P.L.L.C.

  • Family Medicine Physician
  • Shelton, WA
National Provider Identifier
1740482579
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SHELTON FAMILY MEDICINE P.L.L.C.
Practice address
939 Mountain View Drive
Suite 100
Shelton, WA 98584-4410
Phone
(360) 426-2653
Fax
(360) 427-7086
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Mrs. Debra Lee Lanman
Title
Assistant Office Manager
Phone
(360) 426-2653

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

939 Mountain View Drive
Suite 100
Shelton, WA 98584-4410

Mailing address

939 Mountain View Drive
Suite 100
Shelton, WA 98584-4410
Phone (360) 426-2653

National Provider Directory

National Provider Directory
Tax ID family
MGH Shelton Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1015 25th St
Lowr
Anacortes, WA 98221

221 Professional Way
Ste Xx
Shelton, WA 98584

1812 N 13th Loop Rd
Shelton, WA 98584
Phone (360) 426-3862

1810 N 13TH Loop Rd
Shelton, WA 98584

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1740482579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 MOUNTAIN VIEW DRIVE",
            "address_2": "SUITE 100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844410",
            "telephone_number": "360-426-2653",
            "fax_number": "360-427-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 MOUNTAIN VIEW DRIVE",
            "address_2": "SUITE 100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844410",
            "telephone_number": "360-426-2653",
            "fax_number": "360-427-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON FAMILY MEDICINE P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "LANMAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "360-426-2653",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; 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.