NPIMap

Organization Active NPI

Northwest Psychiatric Associates PA

  • Psychiatry Physician
  • Coeur d'Alene, ID
National Provider Identifier
1316023567
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NORTHWEST PSYCHIATRIC ASSOCIATES PA
Practice address
1115 Ironwood Drive
Coeur D Alene, ID 83814-4936
Phone
(208) 765-0955
Fax
(208) 765-6972
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
George Jackson Ullrich, MDNPI 1881788149
Title
President
Phone
(208) 765-0955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1115 Ironwood Drive
Coeur D Alene, ID 83814-4936

Mailing address

PO Box 1356
Coeur D Alene, ID 83816-1356
Phone (208) 765-0955

National Provider Directory

National Provider Directory

Locations

1115 W Ironwood Dr
Coeur D Alene, ID 83814
Phone (208) 665-7178

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316023567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1356",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838161356",
            "telephone_number": "208-765-0955",
            "fax_number": "208-765-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 IRONWOOD DRIVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144936",
            "telephone_number": "208-765-0955",
            "fax_number": "208-765-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PSYCHIATRIC ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ULLRICH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-765-0955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.