NPIMap

Organization Active NPI

Columbia Surgical Specialists, PS

  • Surgery Physician
  • Spokane, WA
National Provider Identifier
1417067372
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
UBI600047769 Issued in WA
Legal business name
COLUMBIA SURGICAL SPECIALISTS, PS
Practice address
217 W Cataldo
Spokane, WA 99201-2217
Phone
(509) 252-2838
Fax
(509) 252-2837
NPI assigned
Aug 30, 2006
Last updated
Dec 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Authorized official

Name
Rod J. Emerson
Title
Ceo
Phone
(509) 624-2326

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X
Otolaryngology Physician 207Y00000X UBI600047769 WA
Surgery Physician 208600000X UBI600047769 WA Primary

Addresses

Primary practice location

217 W Cataldo
Spokane, WA 99201-2217

Mailing address

PO Box 2242
Spokane, WA 99210-2242
Phone (509) 624-2326

Other identifiers 1

IdentifierTypeStateIssuer
7834500MedicaidWA

Other names 1

  • Spokane Ear Nose and Throat Clinic, PS Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000300 WA Part B Supplier - Clinic/Group Practice 2860305505 Receives reassigned benefits from 52 practitioners
Practice locations: Spokane, WA; Spokane Valley, WA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1417067372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2242",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992102242",
            "telephone_number": "509-624-2326",
            "fax_number": "509-252-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CATALDO",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012217",
            "telephone_number": "509-252-2838",
            "fax_number": "509-252-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA SURGICAL SPECIALISTS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "ROD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-624-2326"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "UBI600047769",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "UBI600047769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7834500",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spokane Ear Nose and Throat Clinic, PS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.