Individual provider Active NPI

Kevin Innes, D.O.

  • Emergency Medicine Physician
  • Spokane, WA
National Provider Identifier
1720253172
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP60083073 Issued in WA
Practice address
800 W 5TH Ave
Spokane, WA 99204-2803
Phone
(509) 473-7100
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP60083073 WA Primary

Addresses

Primary practice location

800 W 5TH Ave
Spokane, WA 99204-2803

Mailing address

800 W 5TH Ave
Spokane, WA 99204-2803
Phone (509) 473-7100

Other identifiers 4

IdentifierTypeStateIssuer
1720253172MedicaidMT
1720253172MedicaidWA
17202853172MedicaidID
8543258MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20090821000259 WA Practitioner - Emergency Medicine 7517011737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Emergency Care Physicians PLLCGroup PAC ID 0143554600, 68 clinicians

Practice addresses (Care Compare)

800 W 5TH Ave
Spokane, WA 99204-2803
Phone (509) 473-7101

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Emergency Care Physicians PLLC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Washington Emergency Physician Partners, PLLC Emergency Medicine CurrentSince Feb 1, 2015 Accepting new patients
Washington Emergency Physician Partners PLLC Emergency Medicine CurrentSince Feb 1, 2015 Accepting new patients

Locations

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

8202 N Division St
Spokane, WA 99208
Phone (509) 473-3333

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1720253172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042803",
            "telephone_number": "509-473-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042803",
            "telephone_number": "509-473-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNES",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP60083073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720253172",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720253172",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17202853172",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8543258",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.