Organization Active NPI

Spokane Radiation Oncology Associates P S

  • Radiation Oncology Physician
  • Coeur D Alene, ID
National Provider Identifier
1083607477
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SPOKANE RADIATION ONCOLOGY ASSOCIATES P S
Practice address
700 W Ironwood Dr
Coeur D Alene, ID 83814-2656
Phone
(208) 666-3800
Fax
(208) 666-3817
NPI assigned
Aug 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Dr. David E Davenport, MD
Title
Delegated Official
Phone
(208) 666-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

700 W Ironwood Dr
Coeur D Alene, ID 83814-2656

Mailing address

PO Box 405
Spokane, WA 99210-0405
Phone (208) 667-9334

Other identifiers 1

IdentifierTypeStateIssuer
CN8904OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

101 W 8th Ave
Lowr
Spokane, WA 99204
Phone (509) 474-3336

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

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1083607477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992100405",
            "telephone_number": "208-667-9334",
            "fax_number": "208-664-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-666-3800",
            "fax_number": "208-666-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE RADIATION ONCOLOGY ASSOCIATES P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "208-666-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN8904",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.