Organization Active NPI

Olympia Arthritis & Rehabilitation Clinic Inc PS

  • Legal Medicine
  • Olympia, WA
National Provider Identifier
1952453748
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
MD00024518 Issued in WA
Legal business name
OLYMPIA ARTHRITIS & REHABILITATION CLINIC INC PS
Practice address
1212 Harrison Ave NW
Olympia, WA 98502-5466
Phone
(360) 754-6700
Fax
(360) 357-2202
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Dr. Mark Walter Layton, M.D.NPI 1891846077
Title
President
Phone
(360) 754-6700

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
Legal MedicineGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 173000000X MD00024518 WA Primary

Addresses

Primary practice location

1212 Harrison Ave NW
Olympia, WA 98502-5466

Mailing address

1212 Harrison Ave NW
Olympia, WA 98502-5466
Phone (360) 754-6700

Other identifiers 4

IdentifierTypeStateIssuer
8235038MedicaidWA
126185OtherWAL&I NUMBER YSC
1027689MedicaidWA
12371OtherWAL&I NUMBER MWL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000700 WA Part B Supplier - Clinic/Group Practice 0941193676 Receives reassigned benefits from 2 practitioners
Practice locations: Olympia, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2339868Olympia Arthritis and Rehabilitation Clinic1212 Harrison Ave NW, Olympia, WA 98502ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

Locations

1212 Harrison Ave NW
Olympia, WA 98502
Phone (360) 754-6700

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1952453748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 HARRISON AVE NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025466",
            "telephone_number": "360-754-6700",
            "fax_number": "360-754-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 HARRISON AVE NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025466",
            "telephone_number": "360-754-6700",
            "fax_number": "360-357-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA ARTHRITIS & REHABILITATION CLINIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "LAYTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-754-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "WA",
            "license": "MD00024518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8235038",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER YSC",
            "identifier": "126185",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027689",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER MWL",
            "identifier": "12371",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.