NPIMap

Organization Active NPI

Inland Pediatric Ophthalmology and Strabismus P.L.L.C.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Coeur D Alene, ID
National Provider Identifier
1104472349
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
Legal business name
INLAND PEDIATRIC OPHTHALMOLOGY AND STRABISMUS P.L.L.C.
Practice address
2175 N Main St
Coeur D Alene, ID 83814-5768
Phone
(208) 664-9888
Fax
(208) 666-0816
NPI assigned
Aug 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Sonya Thomas Blizzard, MDNPI 1558629535
Title
Physician
Phone
(208) 274-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0110X Primary

Addresses

Primary practice location

2175 N Main St
Coeur D Alene, ID 83814-5768

Mailing address

2600 E Seltice Way
Ste a PMB#277
Post Falls, ID 83854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201103000694 ID Part B Supplier - Clinic/Group Practice 4587074570 Receives reassigned benefits from 1 practitioner
Practice locations: Coeur D Alene, ID

National Provider Directory

National Provider Directory

Locations

2175 N Main St
Ste A
Coeur D Alene, ID 83814
Phone (208) 664-9888

2600 E Seltice Way
Ste A
Post Falls, ID 83854
Phone (208) 777-0318

2600 E Seltice Way
#277
Post Falls, ID 83854

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1104472349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SELTICE WAY",
            "address_2": "STE A PMB#277",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 N MAIN ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838145768",
            "telephone_number": "208-664-9888",
            "fax_number": "208-666-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND PEDIATRIC OPHTHALMOLOGY AND STRABISMUS P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "BLIZZARD",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-274-3937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.