Active NPI
Deborah Magnuson, APRN
- Pediatric Nurse Practitioner
- Coeur D Alene, ID
National Provider Identifier
1003201138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 74206
- Practice address
- 1090 W Park PL
Coeur D Alene, ID 83814-2785 - Phone
- (208) 215-2005
- Fax
- (844) 807-3782
- NPI assigned
- Apr 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | CNP3754 | MN | |
| Pediatric Nurse Practitioner | 363LP0200X | 74206 | ID | Primary |
Addresses
Primary practice location
1090 W Park PL
Coeur D Alene, ID 83814-2785
Mailing address
PO Box 1387
Hayden, ID 83835-1387
Phone (208) 415-0299
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | deborahmagnuson@rrh.medalliesdirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP3754 | MN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridgecrest Regional Hospital | Current | Accepting new patients |
Locations
1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571
1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Access Hospital
- Ridgecrest, CA
- NPI 1447253125
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1003201138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1387",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838351387",
"telephone_number": "208-415-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1090 W PARK PL",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142785",
"telephone_number": "208-215-2005",
"fax_number": "844-807-3782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNUSON",
"first_name": "DEBORAH",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "CNP3754",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "ID",
"license": "74206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "deborahmagnuson@rrh.medalliesdirect.net",
"affiliation": "N",
"endpointDescription": "RRH Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "1081 N China Lake Blvd",
"city": "Ridgecrest",
"state": "CA",
"country_code": "US",
"postal_code": "935553130",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.