Organization Active NPI

Spokane Cardiology PS

Doing business as Kootenai Heart and Vascular Health

  • Cardiovascular Disease Physician
  • Spokane, WA
National Provider Identifier
1639116452
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SPOKANE CARDIOLOGY PS
Doing business as
Kootenai Heart and Vascular Health
Practice address
910 W 5TH Ave
300
Spokane, WA 99204-2966
Phone
(509) 455-8820
Fax
(509) 838-4978
NPI assigned
Jun 1, 2006
Last updated
Nov 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Carolyn Wicks
Title
Coo
Phone
(509) 455-8820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X WA Primary

Addresses

Primary practice location

910 W 5TH Ave
300
Spokane, WA 99204-2966

Mailing address

910 W 5TH Ave
300
Spokane, WA 99204-2966
Phone (509) 455-8820

Other identifiers 2

IdentifierTypeStateIssuer
11246OtherWAL & I
7826803MedicaidWA

Other names 1

  • Kootenai Heart and Vascular Health Doing business as

National Provider Directory

National Provider Directory

Locations

700 W Ironwood Dr
Ste 214
Coeur D Alene, ID 83814
Phone (208) 292-1600

318 E Rowan Ave
Ste 240
Spokane, WA 99207
Phone (509) 482-2025

Practitioners & affiliated clinicians

Practitioners 5

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": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1639116452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 W 5TH AVE",
            "address_2": "300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042966",
            "telephone_number": "509-455-8820",
            "fax_number": "509-838-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 W 5TH AVE",
            "address_2": "300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042966",
            "telephone_number": "509-455-8820",
            "fax_number": "509-838-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE CARDIOLOGY PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "WICKS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "509-455-8820"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "11246",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7826803",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kootenai Heart and Vascular Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 30, 2007; 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.