Organization Active NPI

Valley Anesthesia, P.a.

  • Anesthesiology Physician
  • Lewiston, ID
National Provider Identifier
1124064647
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
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

Updated by the provider on Jun 18, 2010

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)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
002742700MedicaidID
00274290MedicaidID

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.