Active NPI
Nicholas Rathjen, DO
- Family Medicine Physician
- Tacoma, WA
National Provider Identifier
1740663228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 77299
- Practice address
- Madigan Army Medical Center Family Medicine
Tacoma, WA 98431-5650 - Phone
- (253) 968-0758
- NPI assigned
- Jul 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 77299 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
Madigan Army Medical Center Family Medicine
Tacoma, WA 98431-5650
Mailing address
Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (210) 875-7551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077299 | GA | MD | Licensed Practical Nurse |
| 77299 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633392000000",
"number": "1740663228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "210-875-7551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER FAMILY MEDICINE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984315650",
"telephone_number": "253-968-0758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATHJEN",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-02",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "77299",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.