FRANCISCAN MEDICAL GROUP (NPI# 1154879427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154879427 |
| Entity Type | Organization |
| Organization Name | FRANCISCAN MEDICAL GROUP |
| Other Organization Name | FRANCISCAN PROMPT CARE ON GRAVELLY LAKE |
| Practice Address |
9537 Gravelly Lake Dr Sw Lakewood WA 98499-1513 |
| Practice Telephone | 2539842000 |
| Mailing Telephone | 2539842000 |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |
| Authorized Official Name | MIKE FITZGERALD (CFO) |
| Authorized Official Telephone | 2536804005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Franciscan Prompt Care on Gravelly Lake | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629602016 | Franciscan Medical Group | Emergency Medicine | 3556 Market Pl W Ste 109, University Place, WA 98466-4339 | 2020-02-25 |
| 1497194922 | Franciscan Medical Group | Nurse Practitioner | 9230 Sky Island Drive E, Bonney Lake, WA 98391-7187 | 2013-06-18 |
| 1588944474 | Franciscan Medical Group | Internal Medicine | 424 29th St Ne, Ste D, Puyallup, WA 98372-6766 | 2011-08-23 |
| 1639405137 | Franciscan Medical Group | Podiatrist | 6401 Kimball Dr Nw, Ste 201, Gig Harbor, WA 98335-1228 | 2009-10-19 |
| 1093945677 | Franciscan Medical Group | Plastic Surgery | 11311 Bridgept Way Sw, Ste 309, Lakewood, WA 98499-3071 | 2009-07-17 |
| 1437397361 | Franciscan Medical Group | Physical Medicine & Rehabilitation | 1624 S. I St., Ste 205, Tacoma, WA 98405-5000 | 2009-01-30 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1366539421 | Franciscan Medical Group | Family Medicine | 1717 S J St # Ms 20-15, Tacoma, WA 98405-4933 | 2006-10-09 |
| 1134237696 | Franciscan Medical Group | Surgery | 200 S 333rd St, Ste 150, Federal Way, WA 98003-7359 | 2006-08-26 |
| 1164437851 | Franciscan Medical Group | Podiatrist | 200 Auburn Ave, Auburn, WA 98002-5015 | 2006-07-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | FRANCISCAN MEDICAL GROUP | 2420 S State St, Ms: 20-15, Tacoma, WA 98405-2845 |
| System for Award Management (SAM) Entities | FRANCISCAN MEDICAL GROUP | 1717 S J St, Tacoma, WA 98405-4933 |
| Street Address |
9537 GRAVELLY LAKE DR SW |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235579038 | Minh-triet Dinh Vo | Family Medicine | 9537 Gravelly Lake Dr Sw, Lakewood, WA 98499-1513 | 2013-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265419659 | Brendan J Clark | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2005-12-27 |
| 1558346965 | Julianna Maria Sutarik | Internal Medicine | 274 Union Blvd, Suite 110, Lakewood, CO 80228-1813 | 2005-12-08 |
| 1245644376 | Derek Low | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2014-06-17 |
| 1962745190 | Scott Matson | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2013-04-06 |
| 1346515574 | Kolene Elaine Bailey | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2012-03-21 |
| 1487944997 | Bridget A Graney | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2011-04-18 |
| 1902112337 | Alexander Kogan | Internal Medicine | 274 Union Blvd, Suite 110, Lakewood, CO 80228-1813 | 2010-08-23 |
| 1871720748 | Nathaniel Reid Little | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2009-06-17 |
| 1598932873 | Andrew Waas | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2008-05-14 |
| 1184816159 | Dominic John Titone | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2007-08-14 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.