Coralyn Jill Alexander, MD, PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD00029741 Issued in WA

Practice address

235 E Rowan Ave Ste 220
Spokane, WA 99207-1240

Phone

(509) 474-2223

NPI assigned

Oct 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Coralyn J Hertzberg Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701

  WA

  Medicare reassignment NPD
• Frontier Psychiatry, PLLC

  • Psychiatry Physician
  • Billings, MT
  • NPI 1508493156

  WA

  Medicare reassignment
• Coralyn Alexander MD PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Twin Falls, ID
  • NPI 1861718561
  NPD (past) Authorized official
• Coralyn Alexander MD PA

  • Mental Health Counselor
  • Twin Falls, ID
  • NPI 1962556787
  NPD (past) Authorized official
• Coralyn J Alexander MD PA

  • Psychiatric/Mental Health Nurse Practitioner
  • Twin Falls, ID
  • NPI 1013191915
  NPD (past) Authorized official
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870
  NPD
• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  NPD (past)
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)
• Magic Valley Regional Medical Center

  • Psychiatric Hospital
  • Twin Falls, ID
  • NPI 1447208947
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1194713487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E ROWAN AVE STE 220",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071240",
            "telephone_number": "509-474-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "CORALYN",
        "middle_name": "JILL",
        "credential": "MD, PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M6940",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00029741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "DE757",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "10001359",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804004500",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "coralyn.alexander.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2199 W Ironwood Center Dr",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "322 W North River Dr",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992013208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CORALYN",
            "last_name": "HERTZBERG",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Nicole Aleto
• Thea Christina Alex, L.M.P.
• Marissa Danielle Alexander-Bird, CP61230883, CG611770
• Jillian Jean Alexander-Travers
• Ashley Alexander
• Karen Melissa Alexander, PA-C, CCC-SLP
• Kimberly Gayle Alexander, ARNP
• Susan J Alexander, MD, FACC
• Christine G. Alexanian, LICSW
• Angelica E Alexeyenko

• All providers in Spokane, WA
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.