Active NPI
Joanne T Radakovich, PA-C
- Physician Assistant
- Spokane, WA
National Provider Identifier
1285627307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10003869
- Practice address
- 9001 N Country Homes Blvd
Spokane, WA 99218-2072 - Phone
- (509) 838-2531
- NPI assigned
- Aug 24, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10003869 | WA | Primary |
Addresses
Primary practice location
9001 N Country Homes Blvd
Spokane, WA 99218-2072
Mailing address
PO Box 3649
Spokane, WA 99220-3649
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8328726 | Medicaid | WA |
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
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockwood Clinic PS | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229299200000",
"number": "1285627307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3649",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992203649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9001 N COUNTRY HOMES BLVD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992182072",
"telephone_number": "509-838-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADAKOVICH",
"first_name": "JOANNE",
"middle_name": "T",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-24",
"last_updated": "2008-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10003869",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8328726",
"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 Dec 15, 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.