NPIMap

Organization Active NPI

Integra Imaging, PS

  • Diagnostic Radiology Physician
  • Spokane, WA
National Provider Identifier
1174876437
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
INTEGRA IMAGING, PS
Practice address
801 S Stevens St
Spokane, WA 99204-2654
Phone
(509) 747-4455
Fax
(509) 363-7064
NPI assigned
Oct 23, 2012
Last updated
Oct 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Authorized official

Name
Sarah Russell
Title
Coo
Phone
(509) 747-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

801 S Stevens St
Spokane, WA 99204-2654

Mailing address

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 747-4455

Other names 1

  • Walla Walla Locations Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121204000044 WA Part B Supplier - Clinic/Group Practice 1355593062 Receives reassigned benefits from 151 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20161130001365 MT Part B Supplier - Clinic/Group Practice 1355593062 Receives reassigned benefits from 134 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stevensville, MT; Seeley Lake, MT; Polson, MT; Missoula, MT; Hamilton, MT; Florence, MT; Darby, MT

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

801 S Stevens St
Spokane, WA 99204
Phone (206) 621-4316

103 E Main St
Ste B205
Walla Walla, WA 99362

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1174876437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-747-4455",
            "fax_number": "509-363-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-747-4455",
            "fax_number": "509-363-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA IMAGING, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "509-747-4455"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walla Walla Locations",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.