Spokane Podiatry PS

Primary specialty

PodiatristTaxonomy code 213E00000X

License

601652962 Issued in WA

Legal business name

SPOKANE PODIATRY PS

Practice address

12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133

Phone

(509) 928-1990

Fax

(509) 928-2933

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Stewart Pugmire Brim, DPMNPI 1730297573

Title

Owner

Phone

(509) 928-1990

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medical Foot Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Spokane Podiatry PS

  • Podiatric Clinic/Center
  • Spokane Valley, WA
  • NPI 1083827943

  3072611292

  Same PAC ID

Tax ID family

Spokane Podiatry PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Spokane Podiatry PS

  • Podiatric Clinic/Center
  • Spokane Valley, WA
  • NPI 1083827943
  NPD tax ID

Locations

Practitioners 2

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

• Stewart Pugmire Brim, DPM

  • Podiatrist
  • Spokane Valley, WA
  • NPI 1730297573
  NPD Authorized official
• Darron Woolley, DPM

  • Foot & Ankle Surgery Podiatrist
  • Spokane Valley, WA
  • NPI 1689724601
  NPD

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1306963509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE C",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-928-1990",
            "fax_number": "509-928-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE C",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-928-1990",
            "fax_number": "509-928-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE PODIATRY PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "BRIM",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "PUGMIRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-928-1990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "601652962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9046152",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Foot Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Foot Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Spokane Oms
• Spokane Optical Company LLC
• Spokane Oral and Maxillofacial Surgery ASC
• Spokane Oral Surgery ASC
• Spokane Podiatry PS
• Spokane River Birth Center
• Spokane River Family Wellness PLLC
• Spokane Sinal Decompression Center PS
• Spokane Surgery Center LTD PS
• Spokane Urology PLLC

• Podiatrist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.