NPIMap

Individual provider Active NPI

Donald Douglas Gandy, DO

  • Internal Medicine Physician
  • St Maries, ID
National Provider Identifier
1073552808
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
O-1923 Issued in ID
Practice address
229 S 7TH St Ste 300
St Maries, ID 83861-1803
Phone
(208) 245-2591
Fax
(208) 245-5246
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X O-1923 ID
Internal Medicine Physician 207R00000X O-1923 ID Primary

Addresses

Primary practice location

229 S 7TH St Ste 300
St Maries, ID 83861-1803

Mailing address

229 S 7TH St
St Maries, ID 83861-1803
Phone (208) 245-5551

Other practice location 1

229 S 7th St Ste 101
St Maries, ID 83861-1803
Phone (208) 245-7079

Other practice location 2

229 S 7th St
St Maries, ID 83861-1803
Phone (208) 245-5551

Other names 1

  • Dr. Doug Gandy Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100924001201 NV Practitioner - Emergency Medicine 7315907284
I20240705002103 ID Practitioner - Internal Medicine 7315907284 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benewah Community Hospital 39 clinicians

Practice addresses (Care Compare)

229 S 7TH St
St Maries, ID 83861-1803

Hospital & facility affiliations

  • Hospice of North Idaho Hospice, Coeur D Alene, ID, CCN 131504
  • Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317
  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Benewah Community Hospital Nursing home, CCN 13Z317

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-1923IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Benewah Community Hospital Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Benewah Community Hospital Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Churchill Mangat Emergency Group PC Emergency Medicine Past Accepting new patients
Four States Emergency Physicians Emergency Medicine Past Accepting new patients
Texas Emergency Room Services , PA Emergency Medicine Past Accepting new patients
Ellis Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
G.T. Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
East Texas Medical Center Healthcare Associates Emergency Medicine Past Accepting new patients
Tyler Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

229 S 7th St
Ste 101
St Maries, ID 83861
Phone (208) 245-2591

229 S 7th St
Fl 3
St Maries, ID 83861

229 S 7th St
St Maries, ID 83861
Phone (208) 245-2591

229 S 7th St
Ste 300
St Maries, ID 83861
Phone (208) 245-2591

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e8b4f872-6ea1-4b26-a974-041b5fb4c57b/

Organizations & group practices 10

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 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1073552808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803",
            "telephone_number": "208-245-5551",
            "fax_number": "208-245-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST STE 300",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803",
            "telephone_number": "208-245-2591",
            "fax_number": "208-245-5246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 S 7th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "St Maries",
            "state": "ID",
            "postal_code": "838611803",
            "country_code": "US",
            "telephone_number": "208-245-7079",
            "fax_number": "208-245-5246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 S 7th St",
            "address_purpose": "LOCATION",
            "city": "St Maries",
            "state": "ID",
            "postal_code": "838611803",
            "country_code": "US",
            "telephone_number": "208-245-5551",
            "fax_number": "208-245-2262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDY",
        "first_name": "DONALD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "O-1923",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "O-1923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOUG",
            "last_name": "GANDY",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Maries, ID

Sources for this page

Verify at the official NPI Registry.