NPIMap

Organization Active NPI

Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Rosedale, MD
National Provider Identifier
1972012599
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
5000076869 Issued in MD
Legal business name
IDEAL OPTION, PLLC
Practice address
19 Fontana LN Ste 108
Rosedale, MD 21237-3097
Phone
(509) 222-1275
Fax
(509) 491-3031
NPI assigned
Sep 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Brian Jefferson Dawson, MD
Title
Cmo
Phone
(509) 222-1275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 5000076869 MD Primary

Addresses

Primary practice location

19 Fontana LN Ste 108
Rosedale, MD 21237-3097

Mailing address

8656 W Gage Blvd Ste 301B
Kennewick, WA 99336-7145
Phone (509) 222-1275

Other identifiers 1

IdentifierTypeStateIssuer
577253MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Ideal Option90 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 11

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1972012599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8656 W GAGE BLVD STE 301B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367145",
            "telephone_number": "509-222-1275",
            "fax_number": "509-491-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 FONTANA LN STE 108",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212373097",
            "telephone_number": "509-222-1275",
            "fax_number": "509-491-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL OPTION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JEFFERSON",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "509-222-1275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "5000076869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "577253",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.