Olympia Internal Medicine Assoc.,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00018118 Issued in WA

Legal business name

OLYMPIA INTERNAL MEDICINE ASSOC.,LLC

Practice address

525 Lilly Rd NE
Olympia, WA 98506

Phone

(360) 493-4410

Fax

(360) 493-5511

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gerald J Fay, MD

Title

Owner

Phone

(360) 493-4410

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Jon Widrow, MD

  • Internal Medicine Physician
  • Olympia, WA
  • NPI 1942341417
  Medicare reassignment NPD
• Teresa A Anders, A.R.N.P.

  • Nurse Practitioner
  • Olympia, WA
  • NPI 1508920505
  NPD (past)
• Sheila G Fay, MD

  • Surgery Physician
  • Olympia, WA
  • NPI 1477569150
  NPD (past)
• Jerry Ross Tanner II, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Anchorage, AK
  • NPI 1962580480
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1922031855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-493-4410",
            "fax_number": "360-493-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-493-4410",
            "fax_number": "360-493-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA INTERNAL MEDICINE ASSOC.,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "FAY",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-493-4410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "00018118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7095938",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olympia Family Medicine, Inc.
• Olympia Fertility
• Olympia Health Care Services
• Olympia Health Inc
• Olympia Imaging Center
• Olympia Multi Specialty Clinic
• Olympia Multi-Specialty Clinic Ambulatory Procedures CNTR PLLC
• Olympia Mutual Aid Partners
• Olympia Neurology, PLLC
• Olympia Neurology, PLLC

• Internal Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.