Individual provider Active NPI

Brian P. Fawcett, M.D. / M.P.H.

  • Occupational Medicine Physician
  • Longview, WA
National Provider Identifier
1861559304
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
MD00049070 Issued in WA
Practice address
1405 Delaware St
Longview, WA 98632-2326
Phone
(360) 414-2329
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X MD00049070 WA Primary

Addresses

Primary practice location

1405 Delaware St
Longview, WA 98632-2326

Mailing address

1115 SE 164TH Ave
Dept. 358
Vancouver, WA 98683-9324
Phone (360) 414-2329

Other identifiers 1

IdentifierTypeStateIssuer
MD00049070OtherWASTATE LICENSE

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00049070WAMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Center of Illinois Past Accepting new patients
Orthopaedic Center of Il Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bfawcett3750@direct.peacehealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1861559304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE",
            "address_2": "DEPT. 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839324",
            "telephone_number": "360-414-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322326",
            "telephone_number": "360-414-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWCETT",
        "first_name": "BRIAN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D. / M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WA",
            "license": "MD00049070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD00049070",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.