Christopher Ray Sundquist, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-303 Issued in ID

Practice address

6101 W Hwy 54
Suite a
Athol, ID 83801

Phone

(208) 683-0800

Fax

(208) 683-0900

NPI assigned

Dec 1, 2006

Last updated

Aug 22, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timberlake Family Medicine

  • Primary Care Clinic/Center
  • Athol, ID
  • NPI 1932392933
  NPD (past) Authorized official
• Adams County Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Council, ID
  • NPI 1710915897
  NPD (past)
• Caring Physician's Medical Clinic

  • Family Medicine Physician
  • Hayden, ID
  • NPI 1629139720
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1366510752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775",
            "city": "ATHOL",
            "state": "ID",
            "postal_code": "83801",
            "telephone_number": "208-683-0800",
            "fax_number": "208-683-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 W HWY 54",
            "address_2": "SUITE A",
            "city": "ATHOL",
            "state": "ID",
            "postal_code": "83801",
            "telephone_number": "208-683-0800",
            "fax_number": "208-683-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDQUIST",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "PAD92",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PIN",
            "identifier": "000010158675",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smiles 4 Miles, LLC
• Kelly Sorensen, IBCLC
• Southeast First Assistant LLC
• Charla-Jo Olorenshaw Spradlin, PT
• Amie Lee Storm, LM, CPM
• Timberlake Family Medicine
• True North MHW LLC (True North Mental Health & Wellness)
• Sarah Williams, LPC
• Connie Marie Wilson, FNP

• Medical Physician Assistant in Athol, ID
• Providers in Athol, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.