NPIMap

Organization Active NPI

Physician Anesthesia Group PS

  • Anesthesiology Physician
  • Spokane, WA
National Provider Identifier
1023063278
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHYSICIAN ANESTHESIA GROUP PS
Practice address
104 W 5TH Ave
Suite 230E
Spokane, WA 99204-4880
Phone
(509) 838-8561
Fax
(509) 835-4058
NPI assigned
May 24, 2006
Last updated
Mar 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Dr. Rex Porter, MD
Title
Delegate
Phone
(509) 838-8561

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

104 W 5TH Ave
Suite 230E
Spokane, WA 99204-4880

Mailing address

104 W 5TH Ave
Suite 230E
Spokane, WA 99204-4880
Phone (509) 838-8561

Other identifiers 1

IdentifierTypeStateIssuer
7847700MedicaidWA

National Provider Directory

National Provider Directory

Locations

105 W 8th Ave
#405E
Spokane, WA 99204
Phone (509) 838-8561

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1023063278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "address_2": "SUITE 230E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044880",
            "telephone_number": "509-838-8561",
            "fax_number": "509-835-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "address_2": "SUITE 230E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044880",
            "telephone_number": "509-838-8561",
            "fax_number": "509-835-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ANESTHESIA GROUP PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "DELEGATE",
        "authorized_official_telephone_number": "509-838-8561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7847700",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.