NPIMap

Individual provider Active NPI

Jeffrey B Clode, MD

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1245297712
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00014911 Issued in WA
Practice address
820 S McClellan
#LL10
Spokane, WA 99204
Phone
(509) 353-3973
Fax
(509) 838-8275
NPI assigned
Apr 28, 2006
Last updated
May 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00014911 WA Primary

Addresses

Primary practice location

820 S McClellan
#LL10
Spokane, WA 99204

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 2

IdentifierTypeStateIssuer
1217009MedicaidWA
65719OtherWAL & I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington PastSince Nov 16, 2007 Accepting new patients
Providence Health & Services - Wa PastSince Apr 30, 2003 Accepting new patients
Credena Health LLC PastSince Apr 30, 2003 Accepting new patients
Providence Health & Services - Oregon Internal Medicine PastSince Nov 4, 2010 Accepting new patients
Physicians Clinic of Spokane PS Past Accepting new patients
Providence Health & Services - Washington PastSince Apr 30, 2003 Accepting new patients
Providence Health & Services - Washington Internal Medicine PastSince Oct 27, 2008 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jclode206608@wm.providencedirect.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1245297712",
    "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",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MCCLELLAN",
            "address_2": "#LL10",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99204",
            "telephone_number": "509-353-3973",
            "fax_number": "509-838-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLODE",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00014911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1217009",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "65719",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.