Rina Jannik Missirian, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

M-12406 Issued in ID

Practice address

1090 W Park PL
Coeur D Alene, ID 83814-2785

Phone

(208) 960-2995

NPI assigned

Jul 28, 2006

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

Medicare fee-for-service enrollment

Enrolled in ID

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

State licenses

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1225042138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-960-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-960-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSIRIAN",
        "first_name": "RINA",
        "middle_name": "JANNIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "10303",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "ID",
            "license": "M-12406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Recovery Services PLLC
• Mindful Thoughts
• Mindset Wellness LLP
• Shauna Zemp Miner, ARNP
• Joanna M Minetti, CRNA
• John Bernard Mitchell, M.D.
• Kelly Mitchell, LPC
• Mamie Nora Mitchell, LMSW
• Sarah Mitchell, RN
• Lucy Elizabeth Modahl, MD, PHD

• Geriatric Medicine (Internal Medicine) Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Geriatric Medicine (Internal Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.