Jeffery Edward Fitzthum, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00038676 Issued in WA

Practice address

549 Main St
Edmonds, WA 98020-3149

Phone

(425) 967-6974

Fax

(425) 967-5480

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physical Medicine Northwest

  • Rehabilitation Clinic/Center
  • Edmonds, WA
  • NPI 1932652823
  NPD (past) Authorized official
• Ipp PC

  • Specialist
  • Bothell, WA
  • NPI 1225114929
  NPD (past)
• Sports and Spine

  • Clinic/Center
  • Bellevue, WA
  • NPI 1598255903
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1962434142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203149",
            "telephone_number": "425-967-6974",
            "fax_number": "425-967-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203149",
            "telephone_number": "425-967-6974",
            "fax_number": "425-967-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZTHUM",
        "first_name": "JEFFERY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00038676",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034708",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8254245",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Ivy Figel, RD
• Nusha Ghassemikia File, PT, DPT, OCS
• Lea Fingerhut
• Alexandra Fisher, CBT
• Kiara Fitzpatrick
• Five Corners Pharmacy Inc
• Five Corners Pharmacy Services
• Ann M Fleming, DPT
• Anupma Fleming
• Frank Thomas Flight, DPT

• All providers in Edmonds, WA
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.