Catalyst Medical Group, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

CATALYST MEDICAL GROUP, PLLC

Practice address

1174 Alturas Dr
Moscow, ID 83843-8341

Phone

(208) 743-3523

Fax

(208) 298-4525

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

Karl E Sundberg

Title

Ceo

Phone

(208) 298-3100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1750147450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 8TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017301",
            "telephone_number": "208-746-1383",
            "fax_number": "208-298-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 ALTURAS DR",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838438341",
            "telephone_number": "208-743-3523",
            "fax_number": "208-298-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATALYST MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "SUNDBERG",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-298-3100"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Campbell, RDN, LD
• Katie Campos, FNP-C
• Caren Cox Counseling
• Rachel Carnes, DNP, APRN, FNP-C
• Debby Carscallen, ATC
• Loren Raymond Caudle, LPC
• Jennifer Cervantes Shuffield, LCSW
• Christina Leigh Cervieri, MD
• Songah Chae
• Shelley Lynn Chambers Fox, PHD

• Medical Specialty Clinic/Center in Moscow, ID
• Providers in Moscow, ID by specialty
• Medical Specialty Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.