Lewis Clark Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

LEWIS CLARK IMAGING, LLC

Practice address

336 Warner Dr Ste B
Lewiston, ID 83501-4441

Phone

(360) 391-9311

Fax

(208) 473-7304

NPI assigned

Dec 16, 2022

Last updated

Jun 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ivy Gwost, RVT, RDMS, RDCS

Title

Co-Owner

Phone

(360) 391-9311

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Robert Spurling, M.D

  • Diagnostic Radiology Physician
  • Lewiston, ID
  • NPI 1568464493
  NPD

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1316659899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 WARNER DR STE B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "360-391-9311",
            "fax_number": "208-473-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 WARNER DR STE B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "360-391-9311",
            "fax_number": "208-473-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS CLARK IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "GWOST",
        "authorized_official_first_name": "IVY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "360-391-9311",
        "authorized_official_credential": "RVT, RDMS, RDCS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Scott Leon, MD
• Jennifer Renee Leonard, PHARMD
• Lewis & Clark Orthopaedic Institute LLC
• Lewis Clark Endoscopy, PLLC
• Lewis Clark Gastroenterology PLLC
• Lewis Clark Kidney Center LLC
• Lewis Clark State College
• Lewis-Clark Kidney Center LLC
• Lewis-Clark State College
• Chad Michael Lewis, N.P.

• Radiology Clinic/Center in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Radiology Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.