Nicola L McLachlan, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP628A Issued in ID

Practice address

Lakeside Pediatric & Adolescent Medicine
980 W Ironwood Drive Suite 302
Coeur D Alene, ID 83814

Phone

(208) 667-0585

Fax

(208) 667-0876

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nmclachlan627380@direct.multicare.org

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.

• Lakeside Pediatric & Adolescent Medicine, PLLC

  • Pediatric Adolescent Medicine Physician
  • Coeur D'Alene, ID
  • NPI 1003975087
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1720164122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAKESIDE PEDIATRIC & ADOLESCENT MEDICINE",
            "address_2": "980 W IRONWOOD DRIVE SUITE 302",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-0585",
            "fax_number": "208-667-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAKESIDE PEDIATRIC & ADOLESCENT MEDICINE",
            "address_2": "980 W IRONWOOD DRIVE SUITE 302",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-0585",
            "fax_number": "208-667-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLACHLAN",
        "first_name": "NICOLA",
        "middle_name": "L",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "NP628A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010144440",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP177ID",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806680100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720164122",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9645888",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NPKM0",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "NPPS9",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010144441",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christin J McIntyre, MD, PHD
• Kelli Jo McKee
• Justine Pauline McKellar, LMSW
• Bethany McKim
• Keith Paul McKlendin, MD
• Richard A McLandress, M.D.
• Matthew David McLaughlin, D.O.
• Vicki Ann McLaughlin, LCPC, NCC, CRC, DCC
• James P McMahon, PA-C
• Jennifer McMillan

• Pediatric Nurse Practitioner in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Pediatric Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.