Individual provider Active NPI

Thomas R Pellow, MD

  • Vascular Surgery Physician
  • Spokane, WA
National Provider Identifier
1649233032
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD00021670 Issued in WA
Practice address
122 W 7TH Ave
410 & 420
Spokane, WA 99204-2349
Phone
(509) 838-8286
Fax
(509) 625-1888
NPI assigned
Apr 7, 2006
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD00021670 WA Primary

Addresses

Primary practice location

122 W 7TH Ave
410 & 420
Spokane, WA 99204-2349

Mailing address

122 W 7TH Ave
410 & 420
Spokane, WA 99204-2349
Phone (509) 838-8286

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

LicenseStateTypeSpecialty
MD00021670WAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Imaging Associates, PS Past Accepting new patients
Northwest Cardiac and Vascular Imaging, LLC PastSince Nov 1, 2004 Accepting new patients
Inland Imaging Associates PS Vascular Surgery Past Accepting new patients
Inland Imaging LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1649233032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "410 & 420",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-838-8286",
            "fax_number": "509-625-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "410 & 420",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-838-8286",
            "fax_number": "509-625-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLOW",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD00021670",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 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.

Verify at the official NPI Registry.