North Idaho Neurosurgery and Spine, PLLC

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

M-7768 Issued in ID

Legal business name

NORTH IDAHO NEUROSURGERY AND SPINE, PLLC

Practice address

1641 E. Polston Ave.
Post Falls, ID 83854

Phone

(208) 777-7555

Fax

(208) 777-3337

NPI assigned

Oct 16, 2006

Last updated

Apr 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Dean McDonald, M.D., PH.D.

Title

Owner

Phone

(208) 777-7555

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1134219330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 E. POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-777-7555",
            "fax_number": "208-777-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E. POLSTON AVE.",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-777-7555",
            "fax_number": "208-777-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO NEUROSURGERY AND SPINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-777-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ID",
            "license": "M-7768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806107400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805400800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Idaho Detox
• North Idaho Family Care
• North Idaho Family Physicians, LLC (After Hours Urgent Care Clinic)
• North Idaho Family Practice LLC
• North Idaho Immediate Care
• North Idaho Plastic and Reconstructive Surgery Inc.
• North Idaho Rehabilitation Medicine, PLLC
• North Idaho Worker Care
• Northern Idaho Advanced Care Hospital Inc
• Northern Idaho Advanced Care Hospital Inc (NIACH Physician Group)

• Neuromusculoskeletal Medicine & OMM Physician in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.