FRANCISCAN MEDICAL GROUP (NPI# 1134377070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134377070 |
| Entity Type | Organization |
| Organization Name | FRANCISCAN MEDICAL GROUP |
| Other Organization Name | FMG-NORTHWEST NEPHROLOGY |
| Practice Address |
1708 Yakima Ave #107 Tacoma WA 98405-5307 |
| Practice Telephone | 2532725881 |
| Practice Fax Number | 2533830161 |
| Mailing Telephone | 2532725881 |
| Mailing Fax Number | 2533830161 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-29 |
| Authorized Official Name | DR. CLIFF A. ROBERTSON (PRESIDENT) |
| 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 | 207RN0300X |
Internal Medicine Specialization: Nephrology |
WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| FMG-Northwest Nephrology | 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 |
1708 YAKIMA AVE #107 |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-5307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598758484 | Manuel Guillermo Iregui | Internal Medicine | 1708 Yakima Ave, Suite 300, Tacoma, WA 98405-5307 | 2005-08-25 |
| 1356962401 | Austin Frazer Forbes | Surgery | 1708 Yakima Ave, Tacoma, WA 98405-5307 | 2020-04-29 |
| 1982146684 | Sharleen Huon | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-11-11 |
| 1053853903 | Christine Ibrahim | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-11-09 |
| 1598207524 | Inna Vasilyev | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-11-08 |
| 1346782562 | Shawn Hagland | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-11-07 |
| 1427500867 | Ferowsi Pecoraro | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-11-02 |
| 1700338530 | Cynthia Hinds | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-10-27 |
| 1114477064 | Kayla Grzybowski | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-10-04 |
| 1619427515 | Jessica Chung | Pharmacist | 1708 Yakima Ave, Suite 203, Tacoma, WA 98405-5307 | 2016-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| 1174838676 | Shanza Mujeeb | Internal Medicine | 1708 Yakima Ave Ste 107, Tacoma, WA 98405-5300 | 2010-08-10 |
| 1124065321 | Thomas J Martin | Internal Medicine | 1708 S Yakima Ave, Suite 107, Tacoma, WA 98405 | 2006-05-31 |
| 1962407312 | John A Kennedy | Internal Medicine | 1624 S I St, Ste 303, Tacoma, WA 98405-5093 | 2005-06-14 |
| 1043472806 | Dustin Little | Internal Medicine | Madigan Army Medical Ctr, Bldg 9040, Fitzsimmons Drive, Tacoma, WA 98431-0001 | 2008-07-01 |
| 1184821225 | Ho Won Lee | Internal Medicine | 1901 S Union Ave, Suite B-7011, Tacoma, WA 98405-1702 | 2007-07-02 |
| 1467505933 | Neil R Hannigan M D P S Inc | Internal Medicine | 1708 Yakima Ave, Suite 107, Tacoma, WA 98405-5307 | 2007-01-19 |
| 1215084025 | Melissa Yeh Kaptik | Internal Medicine | 1708 Yakima Ave, #107, Tacoma, WA 98405-5307 | 2007-01-04 |
| 1508926056 | Howard M. Cushner | Internal Medicine | Madigan Army Medical Ctr, 9040 Reid St Attn Mchj Qcr, Tacoma, WA 98431-1100 | 2006-12-12 |
| 1730106568 | Pacific Nephrology Associates, P.s. | Internal Medicine | 1901 S Union Ave, Suite B7011, Tacoma, WA 98405-1702 | 2006-07-17 |
| Find all providers in TACOMA | ||||
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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.