Individual provider Active NPI

Robert L Alan, MD

  • Ophthalmology Physician
  • Bellingham, WA
National Provider Identifier
1780654335
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD00012453 Issued in WA
Practice address
4540 Cordata Pkwy
Suite 103
Bellingham, WA 98226-8059
Phone
(360) 676-8663
Fax
(360) 676-8682
NPI assigned
Jan 25, 2006
Last updated
Dec 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD00012453 WA Primary

Addresses

Primary practice location

4540 Cordata Pkwy
Suite 103
Bellingham, WA 98226-8059

Mailing address

4540 Cordata Pkwy
Suite 103
Bellingham, WA 98226-8059
Phone (360) 676-8663

Other identifiers 4

IdentifierTypeStateIssuer
0013655OtherL AND I
1013002MedicaidWA
0046298OtherL AND I
7063910MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1780654335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 CORDATA PKWY",
            "address_2": "SUITE 103",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268059",
            "telephone_number": "360-676-8663",
            "fax_number": "360-676-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 CORDATA PKWY",
            "address_2": "SUITE 103",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268059",
            "telephone_number": "360-676-8663",
            "fax_number": "360-676-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAN",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00012453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "0013655",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013002",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "0046298",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7063910",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.