Active NPI
Michael K Parent, MD
- Specialist
- Lewiston, ID
National Provider Identifier
1578552139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- M4475
- Practice address
- 1630 23Rd Ave
Suite 701
Lewiston, ID 83501-6350 - Phone
- (208) 743-3998
- Fax
- (208) 746-4879
- NPI assigned
- Oct 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | M4475 | ID | Primary |
Addresses
Primary practice location
1630 23Rd Ave
Suite 701
Lewiston, ID 83501-6350
Mailing address
1630 23Rd Ave
Suite 701
Lewiston, ID 83501-6350
Phone (208) 743-3998
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001224600 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M4475 | ID | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1578552139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 23RD AVE",
"address_2": "SUITE 701",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835016350",
"telephone_number": "208-743-3998",
"fax_number": "208-746-4879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 23RD AVE",
"address_2": "SUITE 701",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835016350",
"telephone_number": "208-743-3998",
"fax_number": "208-746-4879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARENT",
"first_name": "MICHAEL",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ID",
"license": "M4475",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001224600",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.