Richmond Internal Medicine, P.S.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RICHMOND INTERNAL MEDICINE, P.S.

Practice address

355 NW Richmond Beach Rd
Shoreline, WA 98177-3101

Phone

(206) 546-5181

Fax

(206) 546-6575

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David B Jackson, M.D.

Title

President

Phone

(206) 546-5181

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1932159407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773101",
            "telephone_number": "206-546-5181",
            "fax_number": "206-546-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773101",
            "telephone_number": "206-546-5181",
            "fax_number": "206-546-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND INTERNAL MEDICINE, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-546-5181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7073752",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE7285",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Richardson, LCPO
• Kathryn Joy Richardson
• Richmond Beach Rehab LLC
• Richmond Beach Rehab LLC
• Richmond Clinic TR
• Richmond Pediatric Clinic Inc. P.S.
• Richmond Senior Care LLC
• Noah Richmond, LMT
• Kaitlin Rieck, FULL SPECTRUM DOULA
• Shawn J Riedel, MASSAGE THERAPIST

• Internal Medicine Physician in Shoreline, WA
• Providers in Shoreline, 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 Nov 5, 2007; 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.