FRANCISCAN MEDICAL GROUP (NPI# 1336386473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336386473 |
Entity Type | Organization |
Organization Name | FRANCISCAN MEDICAL GROUP |
Other Organization Name | FMG-THORACIC AND VASCULAR CENTER OF KITSAP CO. |
Practice Address |
1225 Campbell Way Suite 101 Bremerton WA 98310-3351 |
Practice Telephone | 3604794203 |
Practice Fax Number | 3604787240 |
Mailing Telephone | 3604794203 |
Mailing Fax Number | 3604787240 |
Enumeration Date | 2009-01-12 |
Last Update Date | 2009-01-12 |
Authorized Official Name | CLIFF A. ROBERTSON (CEO) |
Authorized Official Telephone | 2537796101 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | FRANCISCAN MEDICAL GROUP |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
WA | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
FMG-Thoracic and Vascular Center of Kitsap Co. | 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 |
1225 CAMPBELL WAY SUITE 101 |
City | BREMERTON |
State | WA |
Zip Code | 98310-3351 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831190040 | George A Berni | Surgery | 1225 Campbell Way, Ste 101, Bremerton, WA 98310-3351 | 2005-08-10 |
1063557981 | Roger K Eagan | Specialist | 1225 Campbell Way, Suite 201, Bremerton, WA 98310-3351 | 2007-02-20 |
1356429716 | Michael Lawrence Chernekoff | Physician Assistant | 1225 Campbell Way, Suite 201, Bremerton, WA 98310-3351 | 2006-11-02 |
1033210372 | Alexandra Engstrom | Physician Assistant | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-0000 | 2006-09-26 |
1891806865 | Margaret Mary Krieg | Internal Medicine | 1225 Campbell Way, Suite 201, Bremerton, WA 98310-3351 | 2006-08-31 |
1629016522 | Thoracic & Vascular Center of Kitsap County Inc Ps | Surgery | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-3351 | 2006-06-03 |
1821044918 | Jocelyn C Dela Rosa | Nurse Practitioner | 1225 Campbell Way, Suite 201, Bremerton, WA 98310 | 2006-05-26 |
1134175946 | William Scott Klipper | Internal Medicine | 1225 Campbell Way, Suite 201, Bremerton, WA 98310-3351 | 2006-05-25 |
1609836824 | Griffith Blackmon | Anesthesiology | 1225 Campbell Way, Suite 201, Bremerton, WA 98310-3349 | 2006-03-23 |
1780644096 | David Corley | Internal Medicine | 1225 Campbell Way, Suite 201, Bremerton, WA 98310-3349 | 2006-03-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891333613 | Miss Mary Community Development | Voluntary or Charitable | 1630 Trenton Avenue Apt 10, Bremerton, WA 98310 | 2019-12-11 |
1629636055 | Puget Sound Work Injury Clinic, LLC | Clinic/Center | 812 Cherry Ct, Bremerton, WA 98310 | 2019-05-31 |
1538672530 | Rachel E Mittelstaedt Parsons | Dietitian, Registered | 3059 Viewcrest Dr Ne, Bremerton, WA 98310 | 2017-11-13 |
1356888937 | Sarah Hike | Community Health Worker | 900 Sheridan, Bremerton, WA 98310 | 2017-01-20 |
1073941142 | Hana Singer | Physical Therapy Assistant | 3600 Forest Dr Ne, Bremerton, WA 98310 | 2013-10-28 |
1447508122 | Kevin Lee Hathaway | Mechanotherapist | 3308 Veska Avenue, Bremerton, WA 98310 | 2012-08-28 |
1003163007 | James Hyun Soo Lee | Surgery | Cvn 76 Uss Ronald Reagan, Bremerton, WA 98310 | 2012-08-08 |
1487936241 | Karen S Casseday | Nurse Practitioner | 1740 Ne Riddell Rd Ste 110, Bremerton, WA 98310 | 2011-09-16 |
1740560572 | Lauren P Foresman | Physician Assistant | 2709 Hemlock Street, Bremerton, WA 98310 | 2011-08-24 |
1538390059 | Patricia L Rushon | Speech-Language Pathologist | 560 Lebo Blvd., Bremerton, WA 98310 | 2009-07-31 |
Find all providers in zip 98310 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
1639141658 | George Henry Meier | Surgery | 1225 Campbell Way Ste 101, Bremerton, WA 98310-3323 | 2006-02-03 |
1831190040 | George A Berni | Surgery | 1225 Campbell Way, Ste 101, Bremerton, WA 98310-3351 | 2005-08-10 |
1629016522 | Thoracic & Vascular Center of Kitsap County Inc Ps | Surgery | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-3351 | 2006-06-03 |
1871540088 | Ellis J Salloum | Surgery | 1225 Campbell Way Ste 101, Bremerton, WA 98310 | 2006-05-31 |
1043202450 | Mark C Adams | Surgery | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-3351 | 2005-08-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
1497975361 | Rolando I Celis Valdiviezo | Surgery | 1330 Rockefeller Ave Ste 520, Everett, WA 98201 | 2007-04-26 |
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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.