NPIMap

Organization Active NPI

Skagit Radiology Inc P S

  • Diagnostic Radiology Physician
  • Mount Vernon, WA
National Provider Identifier
1932218757
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SKAGIT RADIOLOGY INC P S
Practice address
1415 E Kincaid
Mount Vernon, WA 98274-4196
Phone
(360) 424-6161
Fax
(360) 848-1167
NPI assigned
Aug 29, 2006
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Kelley Cline, MDNPI 1497941504
Title
Partner
Phone
(360) 424-6161

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

1415 E Kincaid
Mount Vernon, WA 98274-4196

Mailing address

PO Box 2803
Mount Vernon, WA 98273-7803
Phone (360) 428-7274

Other identifiers 2

IdentifierTypeStateIssuer
7599004MedicaidWA
18555OtherWAL&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK, FL, NY, NV, ND, CA7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20040309001447 WA Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 45 practitioners
Practice locations: Kirkland, WA; La Conner, WA; Lynnwood, WA; Mount Vernon, WA; Port Ludlow, WA; Port Townsend, WA; Seattle, WA; Shoreline, WA…
O20100203000380 AK Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 37 practitioners
Practice locations: Fairbanks, AK; Soldotna, AK
O20240819003245 FL Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Pierce, FL; Sarasota, FL
O20250127000038 NY Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY; South Setauket, NY
O20250212003342 NV Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 3 practitioners
Practice locations: Henderson, NV; Las Vegas, NV
O20250723004310 ND Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 1 practitioner
Practice locations: Mandan, ND
O20250813001246 CA Part B Supplier - Clinic/Group Practice 7113815218 Receives reassigned benefits from 2 practitioners
Practice locations: Irvine, CA; Mountain View, CA

National Provider Directory

National Provider Directory

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 47

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.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1932218757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2803",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982737803",
            "telephone_number": "360-428-7274",
            "fax_number": "360-848-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E KINCAID",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744196",
            "telephone_number": "360-424-6161",
            "fax_number": "360-848-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGIT RADIOLOGY INC P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "CLINE",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-424-6161",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7599004",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "18555",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.