Emerald City Sports & Spine Medicine

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD 39116 Issued in WA

Legal business name

EMERALD CITY SPORTS & SPINE MEDICINE

Practice address

1632 116TH Ave NE
Ste C
Bellevue, WA 98004-3035

Phone

(425) 818-0558

Fax

(888) 557-3062

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Garrett S Hyman, MD, MPH

Title

Physician Owner

Phone

(206) 852-8898

Specialties & licenses 1

Addresses

Other names 1

• Lake Washington Sports & Spine Doing business as

Practitioners 2

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

• Gary Phillip Chimes, MD,PHD

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Bellevue, WA
  • NPI 1013032846
  NPD (past)
• Allison Nicole Hyman, DC

  • Chiropractor
  • Bellevue, WA
  • NPI 1568043750
  NPD (past)

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1992074066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 SE ALLEN ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403357",
            "telephone_number": "206-852-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 116TH AVE NE",
            "address_2": "STE C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043035",
            "telephone_number": "425-818-0558",
            "fax_number": "888-557-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD CITY SPORTS & SPINE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "HYMAN",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "206-852-8898",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD 39116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Washington Sports & Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cassandra Joan Ellsworth, LMFT
• Dustin Luke Ellzey, PT, DPT
• Jo Ann Broeckel Elrod, PHD
• Shane Elsdon, LMHC
• Sherman Ely, D.D.S.
• Ian Douglas Emerick, DPT
• Alexis Marie Emery
• John Scott Emery, J.D., M.D.
• Dori Emmons, RD
• Empathic Resilience Counseling, LLC

• Medical Specialty Clinic/Center in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.