Inland Northwest Spine PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

INLAND NORTHWEST SPINE PLLC

Practice address

850 W Ironwood Dr
Suite 300
Coeur D Alene, ID 83814-4903

Phone

(208) 667-1376

Fax

(208) 292-0873

NPI assigned

Oct 11, 2006

Last updated

Jun 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Blaty, DONPI 1639517600

Title

Owner

Phone

(208) 667-1376

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 8

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.

• Douglas Blaty, D.O.

  • Orthopaedic Surgery Physician
  • Coeur d'Alene, ID
  • NPI 1639517600
  Medicare reassignment Care Compare group NPD Authorized official
• Valerie Jo Thomson, FNP-C

  • Family Nurse Practitioner
  • Post Falls, ID
  • NPI 1992096390
  Medicare reassignment Care Compare group NPD
• Bret A Dirks, MD

  • Neurological Surgery Physician
  • Coeur d'Alene, ID
  • NPI 1962508366
  Medicare reassignment NPD
• Sarah Lynn Frank, NP-C

  • Nurse Practitioner
  • Coeur d'Alene, ID
  • NPI 1619330149
  Medicare reassignment NPD
• Stefan Noel Yakel, DO

  • Orthopaedic Surgery of the Spine Physician
  • Coeur d'Alene, ID
  • NPI 1245678085
  Medicare reassignment NPD
• Jennifer Leigh Knigge, ARNP

  • Nurse Practitioner
  • Spokane, WA
  • NPI 1073099123

  ID

  Medicare reassignment NPD
• Drew August Johnson, PA-C

  • Physician Assistant
  • Hayden, ID
  • NPI 1851705347
  Medicare reassignment
• Twyla Jean Masterson, RN, NP

  • Nurse Practitioner
  • Coeur d'Alene, ID
  • NPI 1366548661
  Medicare reassignment

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1700974714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR",
            "address_2": "SUITE 300",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-667-1376",
            "fax_number": "208-292-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR",
            "address_2": "SUITE 300",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-667-1376",
            "fax_number": "208-292-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND NORTHWEST SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "BLATY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-667-1376",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M6482",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Orthopaedic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.