Chattaroy Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00049372 Issued in WA

Legal business name

CHATTAROY FAMILY MEDICINE PLLC

Practice address

23 E. Crawford Ave.
Deer Park, WA 99006

Phone

(509) 276-2554

Fax

(509) 276-2564

NPI assigned

Feb 19, 2010

Last updated

Dec 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Basil M Griffin III, MDNPI 1245206358

Title

President

Phone

(509) 276-2554

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

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.

• Basil Manly Griffin III, M.D.

  • Family Medicine Physician
  • Deer Park, WA
  • NPI 1245206358
  Medicare reassignment NPD Authorized official
• Nathan P Stime, MD

  • Family Medicine Physician
  • Chattaroy, WA
  • NPI 1912976838
  NPD (past)

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1851613749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1304",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990061304",
            "telephone_number": "509-276-2554",
            "fax_number": "509-276-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 E. CRAWFORD AVE.",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "99006",
            "telephone_number": "509-276-2554",
            "fax_number": "509-276-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTAROY FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-19",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "BASIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-276-2554",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00049372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851613749",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Ray Campbell, RN
• Alayna Grace Cantleberry
• Cher Eleanor Carbett, PHARMD
• Cedar Creek Home, LLC
• Cedar Creek Pathways LLC
• Patricia L Cheyne
• Katherina P Choka, ARNP
• Julie M Christiansen, PMHNP-BC
• Clark Dale Christoffersen, DDS
• Elizabeth Anne Chromy, LMP

• Family Medicine Physician in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.