Individual provider Active NPI

David Lynn Chambers, M.D.

  • Family Medicine Physician
  • Coeur D Alene, ID
National Provider Identifier
1700857729
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-4771 Issued in ID
Practice address
920 W Ironwood Dr
Suite 101
Coeur D Alene, ID 83814-2463
Phone
(208) 667-4557
Fax
(208) 765-2887
NPI assigned
Jan 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-4771 ID Primary
Specialist 174400000X M4771 ID

Addresses

Primary practice location

920 W Ironwood Dr
Suite 101
Coeur D Alene, ID 83814-2463

Mailing address

920 W Ironwood Dr
Suite 101
Coeur D Alene, ID 83814-2463
Phone (208) 667-4557

Other identifiers 1

IdentifierTypeStateIssuer
003641300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000318 ID Practitioner - Family Practice 7416840012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M4771IDMDSpecialist
M-4771IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Family Practice, PA Family Medicine CurrentSince Jan 26, 2010 Accepting new patients
Kootenai Health, Inc. Past Accepting new patients

Locations

920 W Ironwood Dr
Ste C
Coeur D Alene, ID 83814
Phone (208) 667-4557

3815 N Schreiber Way
Unit 102
Coeur D Alene, ID 83815
Phone (208) 667-4557

920 W Ironwood Dr
Ste 101
Coeur D Alene, ID 83814
Phone (208) 667-4557

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1700857729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W IRONWOOD DR",
            "address_2": "SUITE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142463",
            "telephone_number": "208-667-4557",
            "fax_number": "208-765-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W IRONWOOD DR",
            "address_2": "SUITE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142463",
            "telephone_number": "208-667-4557",
            "fax_number": "208-765-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-4771",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M4771",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003641300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.