Individual provider Active NPI

Stanley L Hurst

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1891871612
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00016582 Issued in WA
Practice address
Uwmc-Roosevelt
4225 Roosevelt Way NE
Seattle, WA 98105-6166
Phone
(206) 598-4067
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00016582 WA Primary

Addresses

Primary practice location

Uwmc-Roosevelt
4225 Roosevelt Way NE
Seattle, WA 98105-6166

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 3

IdentifierTypeStateIssuer
1891871612MedicaidWA
9658OtherINTERNAL ID-MOTOR VEHICLE ID
0231394OtherWAL&I

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

LicenseStateTypeSpecialty
MD00016582WAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1891871612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UWMC-ROOSEVELT",
            "address_2": "4225 ROOSEVELT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056166",
            "telephone_number": "206-598-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "STANLEY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00016582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891871612",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "9658",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0231394",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.