Lewiston Orthopaedic Associates PA

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

Legal business name

LEWISTON ORTHOPAEDIC ASSOCIATES PA

Practice address

320 Warner Dr
Lewiston, ID 83501-4441

Phone

(208) 743-3523

Fax

(208) 746-8741

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Cindy L Keene

Title

Ceo

Phone

(208) 298-1020

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Lewiston Orthopaedic Associates PA Former legal business name

Practitioners 1

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

• Marvin Renell Kym, MD

  • Orthopaedic Surgery Physician
  • Moscow, ID
  • NPI 1316932601
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1215095252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-743-3523",
            "fax_number": "208-746-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-743-3523",
            "fax_number": "208-746-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWISTON ORTHOPAEDIC ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "KEENE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-298-1020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "ID",
            "license": "BL04-213478",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7849003",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCI",
            "identifier": "89409",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002397200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD IDAHO",
            "identifier": "000010026897",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewiston Orthopaedic Associates PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.