Individual provider Active NPI

Brian James Nibler, PA-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1285746446
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7794 Issued in AZ
Practice address
800 W 5TH Ave
Spokane, WA 99204-2803
Phone
(509) 458-5800
Fax
(509) 473-4926
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10003200 WA
Physician Assistant 363A00000X 7794 AZ Primary
Emergency Medicine Physician 207P00000X PA10003200 WA

Addresses

Primary practice location

800 W 5TH Ave
Spokane, WA 99204-2803

Mailing address

PO Box 34640
Seattle, WA 98124-1640
Phone (509) 458-5800

Other identifiers 3

IdentifierTypeStateIssuer
8325425MedicaidWA
1285746446MedicaidWA
1285746446MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070425000385 WA Practitioner - Physician Assistant 5991800666 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Emergency Care Physicians PLLCGroup PAC ID 0143554600, 68 clinicians

Practice addresses (Care Compare)

12606 E Mission Ave
Spokane Valley, WA 99216-3421
Phone (509) 473-5177

8202 N Division St
Spokane, WA 99208-5713
Phone (509) 473-3333

Hospital & facility affiliations

  • Deaconess Medical Center Hospital, Spokane, WA, CCN 500044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10003200WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Emergency Physician Partners, PLLC Emergency Medicine CurrentSince Feb 1, 2015 Accepting new patients
Spokane Washington Hospital Company LLC Past Accepting new patients
Spokane Emergency Medicine Associates, PS Emergency Medicine Past Accepting new patients

Locations

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

502 W 4th Ave
Toppenish, WA 98948
Phone (509) 575-5000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1285746446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34640",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241640",
            "telephone_number": "509-458-5800",
            "fax_number": "509-473-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042803",
            "telephone_number": "509-458-5800",
            "fax_number": "509-473-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBLER",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003200",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7794",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "PA10003200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8325425",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285746446",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285746446",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.