Individual provider Active NPI

Nicholas Cowley, M.D.

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1043742646
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.61050564 Issued in WA
Practice address
624 E Front Ave
Spokane, WA 99202-2139
Phone
(509) 626-9900
Fax
(509) 626-9920
NPI assigned
Apr 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD.61050564 WA Primary

Addresses

Primary practice location

624 E Front Ave
Spokane, WA 99202-2139

Mailing address

624 E Front Ave
Spokane, WA 99202-2139
Phone (509) 626-9900

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
I20200716002752 WA Practitioner - Internal Medicine 9133543648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Virginia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 482-0111

Hospital & facility affiliations

  • Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077
  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.61050564WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Aug 2, 2020 Accepting new patients
Providence Health & Services Washington Internal Medicine CurrentSince Aug 2, 2020 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

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

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

624 E Front Ave
Spokane, WA 99202
Phone (509) 626-9900

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1043742646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900",
            "fax_number": "509-626-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900",
            "fax_number": "509-626-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWLEY",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-01",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD.61050564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.