Clearwater Neurosciences PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CLEARWATER NEUROSCIENCES PLLC

Practice address

3326 4TH St Ste 6
Lewiston, ID 83501-4455

Phone

(208) 746-2223

Fax

(208) 746-2226

NPI assigned

Nov 24, 2020

Last updated

Nov 24, 2020By 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

Ms. Gail Richardson

Title

Office Manager

Phone

(208) 746-2223

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 3

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.

• Stacy Hill, PH.D.

  • Clinical Neuropsychologist
  • Lewiston, ID
  • NPI 1932492824
  Medicare reassignment NPD
• Natasha Vanessa Demattos, M.D.

  • Neurology Physician
  • Spokane Valley, WA
  • NPI 1922217678

  ID

  Medicare reassignment NPD
• Tauno William Hill, MD

  • Neurological Surgery Physician
  • San Bernardino, CA
  • NPI 1326113325
  NPD (past)

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1760086300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 4TH ST STE 6",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014455",
            "telephone_number": "208-746-2223",
            "fax_number": "208-746-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 4TH ST STE 6",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014455",
            "telephone_number": "208-746-2223",
            "fax_number": "208-746-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER NEUROSCIENCES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-746-2223",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STACY HILL, PH.D.",
            "identifier": "1932492824",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Clark
• Clearview Surgery Center, LLC
• Clearwater Counseling
• Clearwater Gastroenterology
• Clearwater Medical Center PLLC (Clearwater Medical Clinic)
• Clearwater Neurosurgery & Spinal Surgery Associates PLLC
• Clearwater Operations, LLC (Life Care Center of Lewiston)
• Clearwater Orthotics & Prosthetics
• Clearwater Orthotics and Prosthetics, LLC
• Clearwater Valley Optical

• Psychiatry Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.