Palouse Foot & Ankle Clinic

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1298150002 Issued in ID

Legal business name

PALOUSE FOOT & ANKLE CLINIC

Practice address

619 S Washington St
103
Moscow, ID 83843-3090

Phone

(208) 882-8939

Fax

(509) 334-0380

NPI assigned

Jan 2, 2008

Last updated

Jan 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brad J Capawana, DPM

Title

Owner

Phone

(509) 334-4498

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1205011889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD",
            "address_2": "801",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "208-882-8939",
            "fax_number": "509-334-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S WASHINGTON ST",
            "address_2": "103",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433090",
            "telephone_number": "208-882-8939",
            "fax_number": "509-334-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOUSE FOOT & ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "CAPAWANA",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-334-4498",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "1298150002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Moscow, ID
• Providers in Moscow, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.