Organization Active NPI

Alpine Family Medicine

  • Family Medicine Physician
  • Sandpoint, ID
National Provider Identifier
1194253336
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NP-1211A Issued in ID
Legal business name
ALPINE FAMILY MEDICINE
Practice address
1013 Lake St Ste 102
Sandpoint, ID 83864-5002
Phone
(208) 597-7910
NPI assigned
Jun 1, 2017
Last updated
Sep 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Authorized official

Name
Katie Sweeney, FNP
Title
Owner
Phone
(208) 597-7910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NP-1211A ID Primary

Addresses

Primary practice location

1013 Lake St Ste 102
Sandpoint, ID 83864-5002

Mailing address

PO Box 3482
Post Falls, ID 83877-3482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170810001164 ID Part B Supplier - Clinic/Group Practice 3274804109 Receives reassigned benefits from 2 practitioners
Practice locations: Sandpoint, ID

National Provider Directory

National Provider Directory

Locations

1555 Ontario St
Sandpoint, ID 83864
Phone (208) 597-7910

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504569600000",
    "number": "1194253336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3482",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838773482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 LAKE ST STE 102",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645002",
            "telephone_number": "208-597-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-09-05",
        "status": "A",
        "authorized_official_last_name": "SWEENEY",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-597-7910",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "NP-1211A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; 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.