Clearwater Vein Care Center PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00045914 Issued in ID

Legal business name

CLEARWATER VEIN CARE CENTER PC

Practice address

3316 1/2 4TH St
Suite 4B
Lewiston, ID 83501-4460

Phone

(208) 798-7600

Fax

(208) 798-7602

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Alan G Muench, MD

Title

President

Phone

(208) 798-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Trent Matthew Morgan, CRNA

  • Certified Registered Nurse Anesthetist
  • Orofino, ID
  • NPI 1740306828
  NPD (past)
• Mary L Muench, CRNA

  • Certified Registered Nurse Anesthetist
  • Clarkston, WA
  • NPI 1649361007
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1174693196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 1/2 4TH ST",
            "address_2": "SUITE 4B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014460",
            "telephone_number": "208-798-7600",
            "fax_number": "208-798-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 1/2 4TH ST",
            "address_2": "SUITE 4B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014460",
            "telephone_number": "208-798-7600",
            "fax_number": "208-798-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER VEIN CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "MUENCH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-798-7600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "MD00045914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001204900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clearwater Neurosurgery & Spinal Surgery Associates PLLC
• Clearwater Operations, LLC
• Clearwater Orthotics & Prosthetics
• Clearwater Orthotics and Prosthetics, LLC
• Clearwater Valley Optical
• Carrie Ann Coen, PT
• Chuck R Colas, DO
• Misti Collins, LMSW
• Tracy Ann Collins, ATC, LAT
• Catherine Ann Colton, MED

• Specialist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.