Alpine Family Medicine

Organization Active NPI Family Medicine Physician · Sandpoint, ID

NPI 1194253336 · NPPES record last updated Sep 5, 2017

Key facts

NPI
1194253336
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
NP-1211A (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
Organization subpart
No

Authorized official

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

Practitioners 7

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Medicare enrollment records

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

Locations

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

734 9th St W
Ste 12
Columbia Fls, MT 59912
Phone (406) 471-2022

Specialties & licenses

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

Addresses

Primary practice location

1013 Lake St Ste 102
Sandpoint, ID 83864-5002

Mailing address

PO Box 3482
Post Falls, ID 83877-3482

Other providers in Sandpoint, ID

All providers in Sandpoint, ID · Family Medicine Physician in Idaho

Sources for this page

Verify at the official NPI Registry.