NPIMap

Organization Active NPI

Columbia River Medical Center PLLC

  • Family Medicine Physician
  • Pasco, WA
National Provider Identifier
1902939945
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00024811 Issued in WA
Legal business name
COLUMBIA RIVER MEDICAL CENTER PLLC
Practice address
1525 W Court St
Pasco, WA 99301
Phone
(509) 542-9285
Fax
(509) 545-0699
NPI assigned
Mar 13, 2007
Last updated
Jan 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Daniel M Rodriguez
Title
Office Manager
Phone
(509) 542-9285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00024811 WA Primary

Addresses

Primary practice location

1525 W Court St
Pasco, WA 99301

Mailing address

1525 W Court St
Pasco, WA 99301
Phone (509) 542-9285

Other identifiers 1

IdentifierTypeStateIssuer
7113780MedicaidWA

National Provider Directory

National Provider Directory

Locations

1525 W Court St
Pasco, WA 99301
Phone (509) 542-9285

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1902939945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "99301",
            "telephone_number": "509-542-9285",
            "fax_number": "509-545-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "99301",
            "telephone_number": "509-542-9285",
            "fax_number": "509-545-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA RIVER MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-542-9285"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00024811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7113780",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.