Individual provider Active NPI

Christin J McIntyre, MD, PHD

  • Psychiatry Physician
  • Coeur d'Alene, ID
National Provider Identifier
1063588622
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M-16618 Issued in ID
Practice address
1250 W Ironwood Dr Ste 303
Coeur D Alene, ID 83814-2682
Phone
(503) 276-1295
Fax
(234) 444-5496
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD22910 OR
Psychiatry Physician 2084P0800X MD61022782 WA
Psychiatry Physician 2084P0800X M-16618 ID Primary

Addresses

Primary practice location

1250 W Ironwood Dr Ste 303
Coeur D Alene, ID 83814-2682

Mailing address

1250 W Ironwood Dr Ste 303
Coeur D Alene, ID 83814-2682
Phone (503) 276-1295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Sep 10, 2014 through Sep 10, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16618IDMDPsychiatry Physician
MD61022782WAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1063588622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 303",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "503-276-1295",
            "fax_number": "234-444-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 303",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "503-276-1295",
            "fax_number": "234-444-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "CHRISTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD22910",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61022782",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-16618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.