Individual provider Active NPI

Gary Lester Noland, MD

  • Adult Medicine Physician
  • Spokane Valley, WA
National Provider Identifier
1093747719
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OOO17310WA Issued in WA
Practice address
15812 E Indiana Ave
Spokane Valley, WA 99216-1875
Phone
(509) 888-4200
Fax
(509) 444-8206
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X OOO17310WA WA Primary

Addresses

Primary practice location

15812 E Indiana Ave
Spokane Valley, WA 99216-1875

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

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
I20150804005706 WA Practitioner - Family Practice 1254515463 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OOO17310WAWAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane CurrentSince Jul 14, 2015 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane CurrentSince Jul 14, 2015 Accepting new patients

Locations

1203 Idaho St
Lewiston, ID 83501
Phone (208) 848-8300

803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300

203 N Washington St
Ste 300
Spokane, WA 99201

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

611 N Iron Bridge Way
Spokane, WA 99202

15812 E Indiana Ave
Ste 101
Spokane Valley, WA 99216

15812 E Indiana Ave
Spokane Valley, WA 99216

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1093747719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15812 E INDIANA AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161875",
            "telephone_number": "509-888-4200",
            "fax_number": "509-444-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAND",
        "first_name": "GARY",
        "middle_name": "LESTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WA",
            "license": "OOO17310WA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.