Individual provider Active NPI

Jeffery Stuart Givens, MD

  • Family Medicine Physician
  • Spokane Valley, WA
National Provider Identifier
1003890732
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60080776 Issued in WA
Practice address
16528 E Desmet CT
Spokane Valley, WA 99216-3522
Phone
(509) 944-8907
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60080776 WA Primary

Addresses

Primary practice location

16528 E Desmet CT
Spokane Valley, WA 99216-3522

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 944-9644

Other identifiers 6

IdentifierTypeStateIssuer
930635514OtherORGROUP TAX NUMBER
CD8723OtherORRR MEDICARE GROUP NUMBER
R0000WFBTVOtherORGROUP PIN NUMBER
080103355OtherORRR MEDICARE PTAN NUMBER
081443MedicaidOR
1407812365OtherORNBMC NPI NUMBER-GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220124000242 WA Practitioner - Family Practice 2961487962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60080776WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Family Medicine CurrentSince Feb 27, 2022 Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince Feb 27, 2022 Accepting new patients
Kootenai Health, Inc. Past Accepting new patients
Kootenai Health, Inc. Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
North Idaho Family Physicians, LLC Family Medicine Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

16528 E Desmet Ct
Spokane Valley, WA 99216
Phone (509) 944-8910

16528 E Desmet Ct
Ste 1600
Spokane Valley, WA 99216
Phone (509) 944-8900

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1003890732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-944-9644",
            "fax_number": "509-944-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16528 E DESMET CT",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163522",
            "telephone_number": "509-944-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIVENS",
        "first_name": "JEFFERY",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60080776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX NUMBER",
            "identifier": "930635514",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CD8723",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "080103355",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081443",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC NPI NUMBER-GROUP",
            "identifier": "1407812365",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.