Individual provider Active NPI

Starlon Lokidor Ikaal, HCA

  • Adult Care Home Facility
  • Spokane, WA
National Provider Identifier
1760068928
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
784858 Issued in WA
Practice address
5505 S Perry St
Spokane, WA 99223-6344
Phone
(509) 593-0493
Fax
(509) 321-7178
NPI assigned
Mar 18, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 784858 WA Primary

Addresses

Primary practice location

5505 S Perry St
Spokane, WA 99223-6344

Mailing address

5505 S Perry St
Spokane, WA 99223-6344
Phone (509) 593-0493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
784858WAMDAdult Care Home Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Manito Comfort Adult Family Home LLC Adult Care Home CurrentSince Mar 21, 2021 Accepting new patients

Organizations & group practices 1

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": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1760068928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 S PERRY ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992236344",
            "telephone_number": "509-593-0493",
            "fax_number": "509-321-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 S PERRY ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992236344",
            "telephone_number": "509-593-0493",
            "fax_number": "509-321-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKAAL",
        "first_name": "STARLON",
        "middle_name": "LOKIDOR",
        "credential": "HCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "784858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.