NPIMap

Organization Active NPI

Advanced Gastroenterology

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
National Provider Identifier
1962706655
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
50-C0001292 Issued in WA
Legal business name
ADVANCED GASTROENTEROLOGY
Practice address
3250 SE 164TH Ave Ste 205
Vancouver, WA 98683-9313
Phone
(360) 946-4313
Fax
(360) 314-2067
NPI assigned
Jan 10, 2011
Last updated
Nov 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Samuel K SimNPI 1275633844
Title
Partner
Phone
(360) 946-4313

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
Ambulatory Surgical Clinic/Center 261QA1903X 50-C0001292 WA Primary

Addresses

Primary practice location

3250 SE 164TH Ave Ste 205
Vancouver, WA 98683-9313

Mailing address

3250 SE 164TH Ave Ste 205
Vancouver, WA 98683-9313
Phone (360) 946-4313

National Provider Directory

National Provider Directory

Locations

2415 NE 134th St
Ste 205
Vancouver, WA 98686
Phone (360) 576-5060

3250 SE 164th Ave
Ste 205
Vancouver, WA 98683
Phone (360) 946-4313

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1962706655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 SE 164TH AVE STE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839313",
            "telephone_number": "360-946-4313",
            "fax_number": "360-314-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 SE 164TH AVE STE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839313",
            "telephone_number": "360-946-4313",
            "fax_number": "360-314-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "SIM",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-946-4313"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "50-C0001292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.