NPIMap

Organization Active NPI

Multicare Health System

Doing business as ABC Pediatrics by Mary Bridge Children's

  • Pediatrics Physician
  • Olympia, WA
National Provider Identifier
1831609775
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MULTICARE HEALTH SYSTEM
Doing business as
ABC Pediatrics by Mary Bridge Children's
Practice address
1920 Black Lake Blvd SW
Olympia, WA 98512-5651
Phone
(360) 534-9222
NPI assigned
Oct 5, 2017
Last updated
Oct 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Authorized official

Name
Anna Loomis
Title
Sr VP-Chief Financial Office
Phone
(253) 403-8020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1920 Black Lake Blvd SW
Olympia, WA 98512-5651

Mailing address

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

Other names 1

  • ABC Pediatrics by Mary Bridge Children's Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000760 WA Part B Supplier - Clinic/Group Practice 7719899897 Receives reassigned benefits from 4,909 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Covington Urgent Care C99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

10141 224th St E
Graham, WA 98338
Phone (253) 240-0315

1920 Black Lake Blvd SW
Olympia, WA 98512
Phone (360) 534-9222

8011 112th Street Ct E
Puyallup, WA 98373
Phone (253) 848-0662

Practitioners & affiliated clinicians

Practitioners 212

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 212

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1831609775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 BLACK LAKE BLVD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125651",
            "telephone_number": "360-534-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTICARE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "LOOMIS",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "SR VP-CHIEF FINANCIAL OFFICE",
        "authorized_official_telephone_number": "253-403-8020"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC Pediatrics by Mary Bridge Children's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 5, 2017; 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.