Organization Active NPI

Theresa a Burdick MD LLC

  • Obstetrics Physician
  • Seattle, WA
National Provider Identifier
1982870796
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
MD00016175 Issued in WA
Legal business name
THERESA A BURDICK MD LLC
Practice address
801 Broadway Suite 707
Seattle, WA 98122
Phone
(206) 386-3605
Fax
(206) 254-9220
NPI assigned
May 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Theresa A Burdick, MD
Title
President Physician
Phone
(206) 368-3605

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VG0400X MD00016175 WA
Obstetrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VX0000X MD00016175 WA Primary

Addresses

Primary practice location

801 Broadway Suite 707
Seattle, WA 98122

Mailing address

801 Broadway Suite 707
Seattle, WA 98122
Phone (206) 386-3605

Other identifiers 1

IdentifierTypeStateIssuer
1718600MedicaidWA

National Provider Directory

National Provider Directory

Locations

801 Broadway
Ste 707
Seattle, WA 98122
Phone (206) 382-8060

Practitioners & affiliated clinicians

Practitioners 3

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": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1982870796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY SUITE 707",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-386-3605",
            "fax_number": "206-254-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY SUITE 707",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-386-3605",
            "fax_number": "206-254-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA A BURDICK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "BURDICK",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "206-368-3605",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "MD00016175",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WA",
            "license": "MD00016175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1718600",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.