Organization Active NPI

Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1821243742
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FRANCISCAN MEDICAL GROUP
Practice address
1708 Yakima Ave
Suite 60
Tacoma, WA 98405-5307
Phone
(253) 474-9038
Fax
(253) 474-3472
NPI assigned
Nov 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Authorized official

Name
Cliff Robertson
Title
Chief Operations Officer
Phone
(253) 680-4015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1708 Yakima Ave
Suite 60
Tacoma, WA 98405-5307

Mailing address

1708 Yakima Ave
Suite 60
Tacoma, WA 98405-5307
Phone (253) 474-9038

Other identifiers 2

IdentifierTypeStateIssuer
8945600OtherWACRIME VICTIMS
106101525OtherWAOWCP

Other names 1

  • Franciscan Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1821243742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "SUITE 60",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-474-9038",
            "fax_number": "253-474-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "SUITE 60",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-474-9038",
            "fax_number": "253-474-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "253-680-4015"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8945600",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "106101525",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franciscan Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.