Individual provider Active NPI

Robert John Hodgkin, LMP

  • Specialist
  • Woodinville, WA
National Provider Identifier
1750660361
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00001636 Issued in WA
Practice address
17220 127TH PL NE
Suite 101
Woodinville, WA 98072-7965
Phone
(425) 949-2968
NPI assigned
Aug 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00001636 WA Primary

Addresses

Primary practice location

17220 127TH PL NE
Suite 101
Woodinville, WA 98072-7965

Mailing address

23309 3Rd PL W
Bothell, WA 98021-8609
Phone (425) 481-4525

Other identifiers 1

IdentifierTypeStateIssuer
0171143OtherWAWASHINGTON STATE LABOR AND INDUSTRIES

Other names 1

  • John Hodgkin Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00001636WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1750660361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23309 3RD PL W",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218609",
            "telephone_number": "425-481-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17220 127TH PL NE",
            "address_2": "SUITE 101",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980727965",
            "telephone_number": "425-949-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGKIN",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00001636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE LABOR AND INDUSTRIES",
            "identifier": "0171143",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "HODGKIN",
            "credential": "LMP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.