Bainbridge Pediatrics, PLLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

602636742 Issued in WA

Legal business name

BAINBRIDGE PEDIATRICS, PLLC

Practice address

1298 Grow Ave NW
Bainbridge Island, WA 98110

Phone

(206) 780-5437

Fax

(206) 780-5438

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer M. Ottmer

Title

Practice Manager

Phone

(206) 780-5437

Specialties & licenses 1

Addresses

Other names 1

• CWW PLLC Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Kellie Marie Howard, PA-C

  • Physician Assistant
  • Bainbridge Island, WA
  • NPI 1669273413
  NPD (past)
• Molly Sue Linhardt, MD

  • Pediatrics Physician
  • Bainbridge Island, WA
  • NPI 1134273089
  NPD (past)
• Katherine K Schultz, ARNP

  • Family Nurse Practitioner
  • Seattle, WA
  • NPI 1841205556
  NPD (past)
• Frederick Charles Walters, MD

  • Pediatrics Physician
  • Bainbridge Island, WA
  • NPI 1659429793
  NPD (past)
• Rachel Elizabeth Vinson, MD, MPH

  • Pediatrics Physician
  • Glen Ellyn, IL
  • NPI 1508024829
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1851424931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1298 GROW AVE NW",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-780-5437",
            "fax_number": "206-780-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1298 GROW AVE NW",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-780-5437",
            "fax_number": "206-780-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAINBRIDGE PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "OTTMER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "206-780-5437"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "602636742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CWW PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Bainbridge Island Community Pharmacy LLC
• Bainbridge Island Physical Therapy, LLC
• Bainbridge Island School District
• Bainbridge Mental Health, PLLC
• Bainbridge Pediatric Therapy
• Bainbridge Skin Surgery and Consultative Dermatology PLLC
• Bainbridge Vision Inc PS
• Laura West Baker, LMHC
• Michelle Bale
• Lucija Banic

• Pediatric Adolescent Medicine Physician in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Pediatric Adolescent Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.