DR. JOHN BURK GOSSOM MD NPI 1245221886

NPI Information

NPI: 1245221886
Provider Name: DR. JOHN BURK GOSSOM, MD
Classification: Family Medicine - 207QG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
689 AIRPORT CENTER DR
STE B
FRIDAY HARBOR, WA
ZIP 98250
Phone: (360) 378-1338
Get Directions

DR. John Burk Gossom, MD is a geriatric medicine family medicine in Friday Harbor, WA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. DR. John Burk Gossom, MD NPI is 1245221886. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

689 AIRPORT CENTER DR
STE B
FRIDAY HARBOR, WA
ZIP 98250
Phone: (360) 378-1338
Fax: (360) 378-1830

The NPI 1245221886 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/2/2005 and was last updated on 3/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QG0300X	Family Medicine	Geriatric Medicine	MD00018422	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	98250A003	OTHER	TRIWEST
2	532300001	OTHER	GROUP HEALTH
3	912109329	OTHER	FIRST CHOICE
4	5877GO	OTHER	REGENCE BLUE SHIELD
5	8937843	OTHER	CRIME VICTIMS
6	912109329	OTHER	CIGNA BEECH ST
7	361929500	OTHER	US DEPT OF LABOR
8	0152514	OTHER	LABOR AND INDUSTRIES
9	912109329	OTHER	TAX ID
10	912109329	OTHER	COMMUNITY HEALTHPLAN OF W
11	E17984	MEDICARE UPIN
12	912109329	OTHER	PREMERA BLUE CROSS
13	MD00018422	OTHER	LICENSE NUMBER
14	912109329	OTHER	TRIWEST
15	AB23629	MEDICARE ID-TYPE UNSPECIFIED
16	5403470	OTHER	CCN
17	8101404	OTHER	DSHS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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