EMERALD CITY SPORTS & SPINE MEDICINE (NPI# 1992074066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992074066 |
| Entity Type | Organization |
| Organization Name | EMERALD CITY SPORTS & SPINE MEDICINE |
| Other Organization Name | LAKE WASHINGTON SPORTS & SPINE |
| Practice Address |
1632 116th Ave Ne Ste C Bellevue WA 98004-3035 |
| Mailing Address |
6924 Se Allen St Mercer Island WA 98040-3357 |
| Practice Telephone | 4258180558 |
| Practice Fax Number | 8885573062 |
| Mailing Telephone | 2068528898 |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2012-02-22 |
| Authorized Official Name | GARRETT S HYMAN (PHYSICIAN OWNER) |
| Authorized Official Telephone | 2068528898 |
| Authorized Official Credential | MD, MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD 39116 | WA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lake Washington Sports & Spine | Doing Business As Name - Organization |
| Street Address |
1632 116TH AVE NE STE C |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518934199 | Marcia Smith Gordon | Nurse Practitioner | 1632 116th Ave Ne, Suite B, Bellevue, WA 98004-3035 | 2006-03-02 |
| 1558842922 | Jinhee Binder | Nurse Practitioner | 1632 116th Ave Ne, Bellevue, WA 98004-3035 | 2018-08-23 |
| 1033460472 | Blackrock Services Inc | Chiropractor | 1632 116th Ave Ne, Suite C, Bellevue, WA 98004-3035 | 2012-09-25 |
| 1437469442 | Natalia P Novoselova | Massage Therapist | 1632 116th Ave Ne, Bellevue, WA 98004-3035 | 2010-10-12 |
| 1396965844 | Bellevue Bone & Joint Physicians | Orthopaedic Surgery | 1632 116th Ave Ne, Suite C, Bellevue, WA 98004-3035 | 2007-04-26 |
| 1902945009 | Austin Daw-lin Hsu | Chiropractor | 1632 116th Ave Ne, Suite C, Bellevue, WA 98004-3035 | 2007-02-05 |
| 1225187826 | James Eric Clark | Orthopaedic Surgery | 1632 116th Ave Ne, Suite C, Bellevue, WA 98004-3035 | 2007-01-10 |
| 1912056516 | Patricia Angel Shands | Orthopaedic Surgery | 1632 116th Ave Ne, Suite C, Bellevue, WA 98004-3035 | 2007-01-10 |
| 1811057680 | Stephen Bowen Anderson | Specialist | 1632 116th Ave Ne, Ste A, Bellevue, WA 98004-3035 | 2006-12-11 |
| 1023193687 | Bellevue Heart and Vascular Center, LLC | Internal Medicine | 1632 116th Ave Ne, Suite D, Bellevue, WA 98004-3801 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619592946 | Inner Vitality Pllc | Clinic/Center | 11711 Ne 12th St Ste 1a, Bellevue, WA 98005-2461 | 2020-06-12 |
| 1578057337 | Regenerative Medicine Northwest | Clinic/Center | 1260 116th Ave Ne Ste 200, Bellevue, WA 98004-3800 | 2018-06-15 |
| 1871044867 | Eating Recovery Center of Washington | Clinic/Center | 1601 114th Ave Se, Suite #180, Bellevue, WA 98004-6950 | 2016-10-14 |
| 1770971830 | Over Lake Medical Center | Clinic/Center | 1750 112th Ave Ne, Suite A101, Bellevue, WA 98004-3752 | 2014-12-24 |
| 1386048668 | Prohealth Medical, Ltd. | Clinic/Center | 1233 120th Ave Ne, Bellevue, WA 98005-2147 | 2014-10-15 |
| 1790103430 | Dermatology Arts, Pllc | Clinic/Center | 832 102nd Ave Ne, Bellevue, WA 98004-4117 | 2014-03-31 |
| 1295073997 | Bellevue Hyperbarics,pllc | Clinic/Center | 1515 116th Ave Ne, Suite 202, Bellevue, WA 98004-3811 | 2013-01-30 |
| 1629343926 | Rodney J Johnson, Md, Ps, Inc | Clinic/Center | 1600 116th Ave Ne, Suite 302, Bellevue, WA 98004-3014 | 2012-03-20 |
| 1215207204 | Dr. Alex K Oh, Ps | Clinic/Center | 2821 Northup Way, Suite 225, Bellevue, WA 98004-1437 | 2012-01-06 |
| 1942522081 | Np Somnologist, Pllc | Clinic/Center | 16320 Se 15th St, Bellevue, WA 98008-5102 | 2010-02-16 |
| Find all providers in BELLEVUE | ||||
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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.