Active NPI
Stephen E Poore, MD
- Gynecology Physician
- Tacoma, WA
National Provider Identifier
1851316780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- MD00035285
- Practice address
- 4215 49TH Ave NE
Tacoma, WA 98422-2421 - Phone
- (253) 459-7699
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | MD00035285 | WA | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | MD00035285 | WA |
Addresses
Primary practice location
4215 49TH Ave NE
Tacoma, WA 98422-2421
Mailing address
4215 49TH Ave NE
Tacoma, WA 98422-2421
Phone (253) 459-7699
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160040245 | Other | RAILROAD MEDICARE | |
| PO7788 | Other | WA | BLUE SHIELD |
| 0039592 | Other | WA | LABOR & INDUSTRY |
| US1004480 | Other | WA | AETNA/USHC SPECIALIST |
| 8221533 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00035285 | WA | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1851316780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4215 49TH AVE NE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984222421",
"telephone_number": "253-459-7699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4215 49TH AVE NE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984222421",
"telephone_number": "253-459-7699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POORE",
"first_name": "STEPHEN",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "WA",
"license": "MD00035285",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WA",
"license": "MD00035285",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "160040245",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "PO7788",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0039592",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC SPECIALIST",
"identifier": "US1004480",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8221533",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}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 Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.