PEDIATRIX CARDIOLOGY OF WASHINGTON, P.C. (NPI# 1164445367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164445367 |
| Entity Type | Organization |
| Organization Name | PEDIATRIX CARDIOLOGY OF WASHINGTON, P.C. |
| Practice Address |
314 Martin Luther King Jr Way Ste. 303 Tacoma WA 98405-4250 |
| Mailing Address |
770 The City Dr S Suite 4000 Orange CA 92868-4900 |
| Practice Telephone | 2533964868 |
| Practice Fax Number | 2533964870 |
| Mailing Telephone | 8004636628 |
| Mailing Fax Number | 7146203008 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-11-05 |
| Authorized Official Name | ROGER MACK HINSON (PRESIDENT) |
| Authorized Official Telephone | 8004636628 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1164445367 | 05 | |
| AK | MDG20WA | 05 | |
| ID | 1164445367 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PEDIATRIX CARDIOLOGY OF WASHINGTON, P.C. | 1301 Concord Terrace, Sunrise, FL 33323 |
| Street Address |
314 MARTIN LUTHER KING JR WAY STE. 303 |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790785764 | Shauna R Weatherby | Nurse Practitioner | 314 Martin Luther King Jr Way, Ste 104, Tacoma, WA 98405-4250 | 2005-07-29 |
| 1942637251 | Stephanie L Esbenshade | Nurse Practitioner | 314 Martin Luther King Jr Way, Tacoma, WA 98405-4250 | 2013-10-01 |
| 1770839862 | Lynn Allison Lasalle | Occupational Therapist | 314 Martin Luther King Jr Way, Tacoma, WA 98405-4250 | 2012-07-26 |
| 1225396344 | Wonita Shin | Anesthesiology | 314 Martin Luther King Jr Way, Suite 300, Tacoma, WA 98405-4250 | 2012-04-26 |
| 1275807760 | Franciscan Medical Group | Obstetrics & Gynecology | 314 Martin Luther King Jr Way, Ste 400, Tacoma, WA 98405-4250 | 2012-02-29 |
| 1306135496 | Ann Szczepanik | Anesthesiology | 314 Martin Luther King Jr Way, Tacoma, WA 98405-4250 | 2011-03-30 |
| 1477852218 | Wendy Gao | Radiology | 314 Martin Luther King Jr Way, Suite 11, Tacoma, WA 98405 | 2011-03-18 |
| 1841520335 | William M Dean, M.d. P.s. | Specialist | 314 Martin Luther King Jr Way, Ste 103, Tacoma, WA 98405-4250 | 2010-01-05 |
| 1023261989 | Christopher Anthony Bellotti | Pediatrics | 314 Martin Luther King Jr Way, Ste 303, Tacoma, WA 98405-4292 | 2008-10-23 |
| 1346426350 | Prem Arora | Pediatrics | 314 Martin Luther King Jr Way, Suite 103, Tacoma, WA 98405-4250 | 2008-01-21 |
| 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 | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083775902 | Donald L Trippel | Pediatrics | 1901 S Cedar St Ste 103, Tacoma, WA 98405-2302 | 2006-12-13 |
| 1669662417 | Josiah Moises Penalver | Pediatrics | 1901 S Cedar St Ste 103, Tacoma, WA 98405-2302 | 2007-07-27 |
| 1871702068 | Matthew Amandus Studer | Pediatrics | Madigan Army Medical Ctr, Mchj-clp-s, Tacoma, WA 98431-1100 | 2007-05-22 |
| 1881755726 | Roberta Sue Stephenson | Pediatrics | 1901 S Cedar St Ste 103, Tacoma, WA 98405-2302 | 2006-12-13 |
| 1730240599 | Northwest Pediatric Heart Specialists Pllc | Pediatrics | 1901 S Cedar St Ste 103, Tacoma, WA 98405-2302 | 2006-12-13 |
| 1891872008 | Ronald Scott Wells | Pediatrics | 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2006-11-01 |
| 1699875716 | Matthew V. Park | Pediatrics | 314 Martin Luther King Jr Way, #303, Tacoma, WA 98405-4250 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760823801 | Ashish Garg | Pediatrics | 112 Columbia Point Dr Ste 103, Richland, WA 99352-4390 | 2013-07-16 |
| 1164690046 | Jason Deen | Pediatrics | 4745 49th Ave Ne, Seattle, WA 98105-3829 | 2008-02-13 |
| 1225215999 | Agustin Eduardo Rubio | Pediatrics | 4800 Sand Point Way Ne Seattle Children's Hospital, Division of Pediatric Cardiology, G-0035, Seattle, WA 98105-3901 | 2008-01-24 |
| 1760685861 | Brian D Soriano | Pediatrics | 4800 Sand Point Way Ne # G-0035, Seattle, WA 98105-3901 | 2007-06-06 |
| 1689068173 | Joshua John Price | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2015-03-24 |
| 1659787075 | Iman Naimi | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2014-07-07 |
| 1265859375 | Erik L Frandsen | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2014-03-26 |
| 1548603301 | Humera Ahmed | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2013-04-11 |
| 1184966384 | Elizabeth C Caris | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2013-03-26 |
| 1952650145 | Eyal Sagiv | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2012-09-04 |
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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.