Active NPI
Valley Anesthesia, P.a.
- Anesthesiology Physician
- Lewiston, ID
National Provider Identifier
1124064647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- VALLEY ANESTHESIA, P.A.
- Practice address
- 415 6TH St
Lewiston, ID 83501-2431 - Phone
- (208) 743-2511
- NPI assigned
- Jun 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Frank Ditto III, M.D.
- Title
- President
- Phone
- (208) 743-2511
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
415 6TH St
Lewiston, ID 83501-2431
Mailing address
3633 Pacific Ave
Suite 204
Tacoma, WA 98418-7900
Phone (253) 274-1668
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002742700 | Medicaid | ID | |
| 00274290 | Medicaid | ID |
National Provider Directory
National Provider DirectoryLocations
2841 Juniper Dr
Lewiston, ID 83501
Phone (208) 743-8849
3633 Pacific Ave
Ste 204
Tacoma, WA 98418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1276819200000",
"number": "1124064647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3633 PACIFIC AVE",
"address_2": "SUITE 204",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187900",
"telephone_number": "253-274-1668",
"fax_number": "253-274-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 6TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835012431",
"telephone_number": "208-743-2511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VALLEY ANESTHESIA, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-22",
"last_updated": "2010-06-18",
"status": "A",
"authorized_official_last_name": "DITTO",
"authorized_official_first_name": "FRANK",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-743-2511",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002742700",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00274290",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.