Organization Active NPI

Bear Creek Pediatrics

  • Pediatric Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1518470137
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30007917 Issued in WA
Legal business name
BEAR CREEK PEDIATRICS
Practice address
105 W 8TH Ave Ste 7035
Spokane, WA 99204-2313
Phone
(509) 838-1188
NPI assigned
Nov 6, 2017
Last updated
Nov 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
Karen McMahan
Title
Office MGR
Phone
(509) 838-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP30007917 WA Primary

Addresses

Primary practice location

105 W 8TH Ave Ste 7035
Spokane, WA 99204-2313

Mailing address

105 W 8TH Ave Ste 7035
Spokane, WA 99204-2313
Phone (509) 838-1188

Other identifiers 2

IdentifierTypeStateIssuer
2026240MedicaidWA
1048446MedicaidWA

National Provider Directory

National Provider Directory

Locations

105 W 8th Ave
Ste 7035
Spokane, WA 99204
Phone (509) 458-5889

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1518470137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 7035",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042313",
            "telephone_number": "509-838-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 7035",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042313",
            "telephone_number": "509-838-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CREEK PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "MCMAHAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "509-838-1188"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30007917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026240",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1048446",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 6, 2017; 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.