Organization Active NPI

Olympia Cardiac Surgery, Inc., P.S.

  • Specialist
  • Olympia, WA
National Provider Identifier
1780726414
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OLYMPIA CARDIAC SURGERY, INC., P.S.
Practice address
525 Lilly Rd NE
Suite 200
Olympia, WA 98506-5101
Phone
(360) 493-4510
Fax
(360) 493-7759
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Donna Dickinson
Title
Office Manager
Phone
(360) 493-4510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

525 Lilly Rd NE
Suite 200
Olympia, WA 98506-5101

Mailing address

525 Lilly Rd NE
Suite 200
Olympia, WA 98506-5101
Phone (360) 493-4510

Other identifiers 1

IdentifierTypeStateIssuer
7059553MedicaidWA

National Provider Directory

National Provider Directory

Locations

525 Lilly Rd NE
Ste 200
Olympia, WA 98506
Phone (360) 493-4510

525 Lilly Rd NE
#200
Olympia, WA 98506
Phone (360) 493-4510

805 E 2nd St
Casper, WY 82601
Phone (307) 237-2300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1780726414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "address_2": "SUITE 200",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-4510",
            "fax_number": "360-493-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "address_2": "SUITE 200",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-4510",
            "fax_number": "360-493-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA CARDIAC SURGERY, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-493-4510"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7059553",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.