Robert I Hustrulid MD PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ROBERT I HUSTRULID MD PLLC

Practice address

1201 N Evergreen Rd
Spokane Valley, WA 99216-5094

Phone

(509) 951-3979

Fax

(509) 495-1244

NPI assigned

Sep 28, 2020

Organization subpart

No

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

Authorized official

Name

Robert Iver Hustrulid, MDNPI 1528079217

Title

Owner

Phone

(509) 951-3979

Specialties & licenses 1

Addresses

Other names 1

• Country Doctors Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22456/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Robert Iver Hustrulid, M.D.

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1528079217
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1265049829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 S SOMMER RD",
            "city": "VERADALE",
            "state": "WA",
            "postal_code": "990379136",
            "telephone_number": "509-951-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N EVERGREEN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165094",
            "telephone_number": "509-951-3979",
            "fax_number": "509-495-1244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3807 S Sommer Rd",
            "address_purpose": "LOCATION",
            "city": "Veradale",
            "state": "WA",
            "postal_code": "990379136",
            "country_code": "US",
            "telephone_number": "509-951-3979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROBERT I HUSTRULID MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "HUSTRULID",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "IVER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-951-3979",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Doctors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dakotah Alan Roach, PTA
• Jesica Robb
• Brandon Roberson, MS,OTR
• Summer Lynn Roberson
• Robert B Burr PHD PS
• Robert L. Wilder DDS PS
• Robert Maher MD Robert Davis MD Et Al
• Cynthia K. Roberts Hollon, ARNP
• Ann M Roberts, MD
• Brenda Lea Roberts, LICSW, LCSW

• Internal Medicine Physician in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.