Active NPI
Robert Anthony Norum, MD
- Dermatology Physician
- Edmonds, WA
National Provider Identifier
1811965627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD00030747
- Practice address
- 6230 138 Place SW
Edmonds, WA 98026-3241 - Phone
- (425) 742-5289
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD00030747 | WA | Primary |
| Internal Medicine Physician | 207R00000X | MD00030747 | WA |
Addresses
Primary practice location
6230 138 Place SW
Edmonds, WA 98026-3241
Mailing address
6230 138 Place SW
Edmonds, WA 98026-3241
Phone (425) 742-5289
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8152928 | Medicaid | WA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00030747 | WA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1811965627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6230 138 PLACE SW",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980263241",
"telephone_number": "425-742-5289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6230 138 PLACE SW",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980263241",
"telephone_number": "425-742-5289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORUM",
"first_name": "ROBERT",
"middle_name": "ANTHONY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "MD00030747",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00030747",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8152928",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
- Northwest Dental Center, Inc
- Northwest Foot & Ankle Associates, P.S.
- Northwest Foot & Ankle Associates, P.S.
- Northwest Naturopathic and Pain Clinic
- Northwest Pulmonology Physicians PC
- Lisa Dawn Nott, COTA/L
- Nova Family Resource and Childcare Center, LLC
- Asha Novak, R.N., L.AC.
- Edward Macarthur Noyes, MD
- Nutrition With Heart LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.