Stephen Penaskovic

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00031704 Issued in WA

Practice address

101 W 8TH Ave
Spokane, WA 99205-4805

Phone

(509) 474-3131

NPI assigned

Sep 20, 2006

Last updated

May 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1114025251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12229",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852229",
            "telephone_number": "888-432-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054805",
            "telephone_number": "509-474-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENASKOVIC",
        "first_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00031704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8155822",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Charles Peloso III, CP 61341135
• Christie Ann Pelz, LASW, MHP, CMHS
• Jennifer Pelzel
• Amy Marie Pemberton, DPT
• Jaya Praveen Kumar Penagaluri
• Asha Pence, M.S., CCC-SLP
• Jennifer L Pence, DPT
• Marisa Diane Pendergrass, LMP
• Jaylah Danielle Pendleton, LMSW
• Jessica Pendleton

• Emergency Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.