DR. JAMES ROBERT FACKELMAN (NPI# 1417939331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417939331 |
| Entity Type | Individual |
| Full Name | DR. JAMES ROBERT FACKELMAN |
| Credential | MD |
| Practice Address |
10555 Se Carr Rd Renton WA 98055-5820 |
| Mailing Address |
Po Box 34876 Seattle WA 98124-1876 |
| Practice Telephone | 4256564270 |
| Practice Fax Number | 4256564271 |
| Mailing Telephone | 4256565412 |
| Mailing Fax Number | 4256564096 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD00024483 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
10555 SE CARR RD |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679018063 | Lindsey Paige O'donnell | Physician Assistant | 10555 Se Carr Rd, Bldg M, Renton, WA 98055-5820 | 2016-12-21 |
| 1003202870 | Padhma Venkitapathy | Podiatrist | 10555 Se Carr Rd, Renton, WA 98055 | 2015-04-08 |
| 1184989451 | Nick Nghia Dang | Podiatrist | 10555 Se Carr Rd, Bldg M, Renton, WA 98055-5820 | 2012-07-11 |
| 1760620132 | Public Hospital District#1 of King County | Family Medicine | 10555 Se Carr Rd, Ste M, Renton, WA 98055-5820 | 2009-01-23 |
| 1821245333 | Michael Stiranka | Physician Assistant | 10555 Se Carr Rd, Bldg M, Renton, WA 98055-5820 | 2008-08-27 |
| 1629245865 | Public Hospital District #1 of King County | Family Medicine | 10555 Se Carr Rd, Ste M, Renton, WA 98055-5820 | 2008-05-15 |
| 1346258936 | Negar Ayoubzadeh-bartos | Physician Assistant | 10555 Se Carr Rd, Bldg M, Renton, WA 98055-5820 | 2006-08-03 |
| 1528087285 | Kennard D Mcnichols | Family Medicine | 10555 Se Carr Rd, Renton, WA 98055-5820 | 2006-07-19 |
| 1285607606 | Reza Roy Berjis | Family Medicine | 10555 Se Carr Rd, Renton, WA 98055-5820 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1760541734 | Debra Susan Fetherston | Internal Medicine | 275 Bronson Way Ne, Renton, WA 98056-4030 | 2006-12-06 |
| 1043318629 | Khairunnissa S Rajwani | Internal Medicine | 2418 Se 2nd Pl, Renton, WA 98056-8876 | 2006-09-20 |
| 1235146077 | Emad Nabil Girgis | Internal Medicine | 17600 Talbot Rd S, Suite 5, Renton, WA 98055-5788 | 2006-08-02 |
| 1447270970 | Gene Y Hao | Internal Medicine | 606 Oakesdale Ave Sw, Suite C200, Renton, WA 98057-5227 | 2006-07-20 |
| 1205860509 | Marta E Long | Internal Medicine | 275 Bronson Way Se, Renton, WA 98056 | 2006-07-10 |
| 1700812237 | Margaret R Adam | Internal Medicine | 64 Rainier Ave S, Renton, WA 98057 | 2006-06-25 |
| 1952369498 | Khue Dung Lucy Nguyen | Internal Medicine | 660 Sw 39th St, Ste 150, Renton, WA 98057-4912 | 2006-05-03 |
| 1013987841 | Ting-wei Yang | Internal Medicine | 4011 Talbot Rd S Ste 500, Renton, WA 98055-5782 | 2006-01-24 |
| 1730172008 | Margaret Fillmore Gaines | Internal Medicine | 606 Oakesdale Ave Sw Ste C200, Renton, WA 98057 | 2005-08-23 |
| 1598222564 | Eastside Tms X Wellness Center | Internal Medicine | 15 S Grady Way Ste 625, Renton, WA 98057-3281 | 2019-02-26 |
| Find all providers in RENTON | ||||
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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.