Active NPI
Leonard E. Murray, PA-C
- Surgical Physician Assistant
- Spokane, WA
National Provider Identifier
1639178973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA10000542
- Practice address
- 122 W 7TH Ave
Ste 110
Spokane, WA 99204-2349 - Phone
- (509) 456-0262
- Fax
- (509) 462-5059
- NPI assigned
- Jul 19, 2005
- Last updated
- Dec 19, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA10000542 | WA | Primary |
| Surgical Physician Assistant | 363AS0400X | PA-469 | ID |
Addresses
Primary practice location
122 W 7TH Ave
Ste 110
Spokane, WA 99204-2349
Mailing address
122 W 7TH Ave
Ste 110
Spokane, WA 99204-2349
Phone (509) 456-0262
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16654731 | Other | ID | MEDICARE PTAN |
| 8374795 | Medicaid | WA | |
| G8871063 | Other | WA | MEDICARE PTAN |
| 003237300 | Medicaid | ID | |
| G8878131 | Other | WA | MEDICARE PTAN |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-469 | ID | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1639178973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 W 7TH AVE",
"address_2": "STE 110",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042349",
"telephone_number": "509-456-0262",
"fax_number": "509-462-5059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 W 7TH AVE",
"address_2": "STE 110",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042349",
"telephone_number": "509-456-0262",
"fax_number": "509-462-5059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRAY",
"first_name": "LEONARD",
"middle_name": "E.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WA",
"license": "PA10000542",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "ID",
"license": "PA-469",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "16654731",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8374795",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "G8871063",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003237300",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "G8878131",
"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 Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.