North Idaho Endoscopy Center PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTH IDAHO ENDOSCOPY CENTER PLLC

Practice address

1607 Lincoln Way Suite 100
Coeurdalene, ID 83814-2476

Phone

(208) 665-9184

Fax

(208) 665-7964

NPI assigned

Jun 29, 2005

Last updated

Dec 29, 2011By 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. Gavin S Young, M.D.

Title

Medical Director

Phone

(208) 665-9184

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• R Randy Hopkins, MD

  • Gastroenterology Physician
  • Coeur d'Alene, ID
  • NPI 1548339047
  NPD (past)

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1154328763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 LINCOLN WAY SUITE 100",
            "city": "COEURDALENE",
            "state": "ID",
            "postal_code": "838142476",
            "telephone_number": "208-665-9184",
            "fax_number": "208-665-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 LINCOLN WAY SUITE 100",
            "city": "COEURDALENE",
            "state": "ID",
            "postal_code": "838142476",
            "telephone_number": "208-665-9184",
            "fax_number": "208-665-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO ENDOSCOPY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "208-665-9184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010138610",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "04358",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806363500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "490005464",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "23856",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Idaho Day Surgery LLC
• North Idaho Day Surgery LLC
• North Idaho Day Surgery LLC
• North Idaho Dermatology, Inc.
• North Idaho Endoscopy and Surgical Specialists, PLLC
• North Idaho Eye Institute P a (Coeur D Alene Eye Clinic Post Falls Eye Clinic)
• North Idaho Family Physicians (Bone Density of North Idaho)
• North Idaho Family Physicians, LLC (After Hours Urgent Care Clinic)
• North Idaho Gastroenterology PLLC
• North Idaho Hand Rehabilitation, PLLC

• Ambulatory Surgical Clinic/Center in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.