Individual provider Active NPI

Vicky M Lott, M.D.

  • Family Medicine Physician
  • Moscow, ID
National Provider Identifier
1184707952
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M8278 Issued in ID
Practice address
623 South Main Street
Moscow, ID 83843
Phone
(208) 882-2011
Fax
(208) 883-1853
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00040077 WA
Family Medicine Physician 207Q00000X M8278 ID Primary

Addresses

Primary practice location

623 South Main Street
Moscow, ID 83843

Mailing address

623 South Main Street
Moscow, ID 83843
Phone (208) 882-2011

Other practice location 1

825 SE Bishop Blvd Ste 401
Pullman, WA 99163-5517
Phone (509) 336-7720

Other identifiers 8

IdentifierTypeStateIssuer
1104639OtherIDDMERC
806323500OtherIDHEATHY CONNECTIONS
1004375MedicaidWA
48264OtherIDBLUE CROSS
000010138246OtherIDREGENCE BLUESHIELD
0159575OtherWAWA LABOR & INDUSTRIES
806323500MedicaidID
8298937MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240528002853 WA Practitioner - Family Practice 7810078243 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Jul 1, 2024 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients
Washington State University Family Medicine Past Accepting new patients
Valley Medical Center, PLLC PastSince Nov 26, 2007 Accepting new patients

Locations

825 SE Bishop Blvd
Ste 401
Pullman, WA 99163
Phone (509) 336-7720

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

840 SE Bishop Blvd
Ste 103
Pullman, WA 99163
Phone (509) 336-7300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1184707952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 SOUTH MAIN STREET",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-882-2011",
            "fax_number": "208-883-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 SOUTH MAIN STREET",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-882-2011",
            "fax_number": "208-883-1853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 SE Bishop Blvd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991635517",
            "country_code": "US",
            "telephone_number": "509-336-7720",
            "fax_number": "509-715-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOTT",
        "first_name": "VICKY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040077",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M8278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1104639",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEATHY CONNECTIONS",
            "identifier": "806323500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004375",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "48264",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "000010138246",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "0159575",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806323500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8298937",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.