Northwest Physicians and Surgeons

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

NORTHWEST PHYSICIANS AND SURGEONS

Practice address

850 W Ironwood Dr Ste 301
Coeur D Alene, ID 83814-4903

Phone

(208) 667-9762

Fax

(208) 765-1041

NPI assigned

Oct 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Cory Averill Johnson, DPMNPI 1730665837

Title

Owner/Provider

Phone

(208) 667-9762

Specialties & licenses 1

Addresses

Other names 1

• Cory Averill Johnson Other name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Cory A Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Coeur D Alene, ID
  • NPI 1730665837

  2062810401

  Same PAC ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cory A Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Coeur D Alene, ID
  • NPI 1730665837
  Medicare reassignment Care Compare group NPD Authorized official
• Tara Ashley Dorosh, PA-C

  • Physician Assistant
  • Coeur D Alene, ID
  • NPI 1558868067
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1023780376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR STE 301",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-667-9762",
            "fax_number": "208-765-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR STE 301",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-667-9762",
            "fax_number": "208-765-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHYSICIANS AND SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "AVERILL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "208-667-9762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cory Averill Johnson",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• North Star Child Development Center
• Northwest Behavioral Healthcare
• Northwest Counseling LLC
• Northwest Endodontics PC
• Northwest Nutrition Consulting
• Northwest Psychiatric Associates PA
• Aaron J Notestine, M.D.
• Ashely Wells Notestine, LCPC 7410
• Nourished Body
• Annmarie Nugent

• Foot & Ankle Surgery Podiatrist in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.