Individual provider Active NPI

Manuela Orban, ARNP

  • Nurse Practitioner
  • Coeur d'Alene, ID
National Provider Identifier
1063801694
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
56759 Issued in ID
Practice address
6240 N Cezanne Dr
Coeur D Alene, ID 83815-9132
Phone
(909) 801-1533
NPI assigned
Jan 20, 2015
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 56759 ID Primary
Family Nurse Practitioner 363LF0000X AP60534587 WA

Addresses

Primary practice location

6240 N Cezanne Dr
Coeur D Alene, ID 83815-9132

Mailing address

PO Box 3649
Spokane, WA 99220-3649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710002992 ID Practitioner - Nurse Practitioner 8921327461 Practice locations: Coeur D Alene, ID

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
56759IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avant-Garde Healthcare PLLC Nurse Practitioner CurrentSince Apr 26, 2024 Accepting new patients
Rockwood Clinic PS Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1063801694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 N CEZANNE DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159132",
            "telephone_number": "909-801-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORBAN",
        "first_name": "MANUELA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-20",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "56759",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60534587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.