NPIMap

Individual provider Active NPI

Dominique Justin Pepper, MD

  • Pulmonary Disease Physician
  • Olympia, WA
National Provider Identifier
1750691713
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD60818088 Issued in WA
Practice address
500 Lilly Rd NE Ste 201
Olympia, WA 98506
Phone
(360) 413-8272
Fax
(360) 413-8878
NPI assigned
Oct 8, 2010
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD60818088 WA Primary

Addresses

Primary practice location

500 Lilly Rd NE Ste 201
Olympia, WA 98506

Mailing address

PO Box 3360
Portland, OR 97208-3360

Other identifiers 1

IdentifierTypeStateIssuer
796-LOtherMSMS. TEMPORARY MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dpepper899399@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829002797 WA Practitioner - Pulmonary Disease 4183923311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1624 S I St
Suite 405
Tacoma, WA 98405-5094
Phone (253) 274-4545

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60818088WAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jul 1, 2018 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Pulmonary Disease CurrentSince Jun 23, 2025 Accepting new patients
Providence Health & Services Washington CurrentSince Jul 1, 2018 Accepting new patients
Franciscan Medical Group CurrentSince Jun 23, 2025 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

500 Lilly Rd NE
Ste 201
Olympia, WA 98506
Phone (360) 413-8272

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

1624 S I St
Ste 405
Tacoma, WA 98405
Phone (253) 274-4545

1708 Yakima Ave
Ste 300
Tacoma, WA 98405
Phone (253) 363-8700

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1750691713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LILLY RD NE STE 201",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-413-8272",
            "fax_number": "360-413-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "DOMINIQUE",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60818088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS. TEMPORARY MEDICAL LICENSE",
            "identifier": "796-L",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpepper899399@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 Lilly Rd NE Ste 201",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.