Theran Adamson, MD PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-12662 Issued in ID

Legal business name

THERAN ADAMSON, MD PLLC

Practice address

914 W Ironwood Dr
Ste 102
Coeur D Alene, ID 83814-4927

Phone

(208) 765-5922

NPI assigned

Jan 25, 2017

Organization subpart

No

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

Authorized official

Name

Theran Adamson, MD

Title

Owner

Phone

(208) 765-5922

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1295272490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 W IRONWOOD DR",
            "address_2": "STE 102",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144927",
            "telephone_number": "208-765-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 W IRONWOOD DR",
            "address_2": "STE 102",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144927",
            "telephone_number": "208-765-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAN ADAMSON, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "ADAMSON",
        "authorized_official_first_name": "THERAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-765-5922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-12662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID LICENSE",
            "identifier": "M-12662",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.