NPIMap

Organization Active NPI

Madigan Army Medical Ctr

Doing business as Madigan-South Sound Community Medical Home

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Olympia, WA
National Provider Identifier
1881907822
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
MADIGAN ARMY MEDICAL CTR
Doing business as
Madigan-South Sound Community Medical Home
Practice address
3415 Pacific Ave SE
Suite D1
Olympia, WA 98501-2173
Phone
(253) 982-0412
NPI assigned
Jul 20, 2010
Last updated
Apr 13, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MADIGAN ARMY MEDICAL CTRAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Karen Mady
Title
TPC Manager
Phone
(253) 968-6598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X NU Primary

Addresses

Primary practice location

3415 Pacific Ave SE
Suite D1
Olympia, WA 98501-2173

Mailing address

9040A Jackson Ave
Attn: MCHJ-Csa-U
Tacoma, WA 98431-0001
Phone (253) 968-6598

Other identifiers 1

IdentifierTypeStateIssuer
1841390077OtherPARENT BILLING NPI

Other names 1

  • Madigan-South Sound Community Medical Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
US Army33 organizations share this tax ID, including this one
Part of
US Army

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

3415 Pacific Ave SE
Ste D1
Olympia, WA 98501
Phone (253) 982-0412

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1881907822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVE",
            "address_2": "ATTN: MCHJ-CSA-U",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 PACIFIC AVE SE",
            "address_2": "SUITE D1",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012173",
            "telephone_number": "253-982-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADIGAN ARMY MEDICAL CTR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADIGAN ARMY MEDICAL CTR",
        "enumeration_date": "2010-07-20",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "MADY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "TPC MANAGER",
        "authorized_official_telephone_number": "253-968-6598"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT BILLING NPI",
            "identifier": "1841390077",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madigan-South Sound Community Medical Home",
            "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 Apr 13, 2015; 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.