NPIMap

Organization Active NPI

Womens Clinic of North Idaho

  • Obstetrics & Gynecology Physician
  • Coeur d'Alene, ID
National Provider Identifier
1649358268
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMENS CLINIC OF NORTH IDAHO
Practice address
980 W Ironwood Drive
Suite 306
Coeur D Alene, ID 83814-2601
Phone
(208) 664-3101
Fax
(208) 664-9713
NPI assigned
Nov 1, 2006
Last updated
Jan 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Authorized official

Name
Dr. Frederick P Ambrose, M.D.NPI 1396816096
Title
President
Phone
(208) 664-3101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

980 W Ironwood Drive
Suite 306
Coeur D Alene, ID 83814-2601

Mailing address

980 W Ironwood Drive
Suite 306
Coeur D Alene, ID 83814-2601
Phone (208) 664-3101

Other identifiers 1

IdentifierTypeStateIssuer
002427200MedicaidID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263772800000",
    "number": "1649358268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DRIVE",
            "address_2": "SUITE 306",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142601",
            "telephone_number": "208-664-3101",
            "fax_number": "208-664-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DRIVE",
            "address_2": "SUITE 306",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142601",
            "telephone_number": "208-664-3101",
            "fax_number": "208-664-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS CLINIC OF NORTH IDAHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-01-18",
        "status": "A",
        "authorized_official_last_name": "AMBROSE",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-664-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002427200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.