NPIMap

Organization Active NPI

Inland Northwest Surgery Center PLLC

Doing business as Family Foot Center

  • Podiatrist
  • St Maries, ID
National Provider Identifier
1770013443
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P-224 Issued in ID
Legal business name
INLAND NORTHWEST SURGERY CENTER PLLC
Doing business as
Family Foot Center
Practice address
229 S 7TH St
St Maries, ID 83861-1803
Phone
(509) 924-2600
NPI assigned
Jun 15, 2017
Last updated
Jun 15, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Authorized official

Name
Trena Lundstrom
Title
Manager
Phone
(509) 924-2600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 6011706837 WA
Podiatrist 213E00000X P-224 ID Primary

Addresses

Primary practice location

229 S 7TH St
St Maries, ID 83861-1803

Mailing address

526 N Mullan Rd
Spokane Valley, WA 99206-2408
Phone (509) 924-2600

Other names 1

  • Family Foot Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Inland NW Surgery Ctr PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1770013443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 N MULLAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992062408",
            "telephone_number": "509-924-2600",
            "fax_number": "509-926-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803",
            "telephone_number": "509-924-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND NORTHWEST SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "LUNDSTROM",
        "authorized_official_first_name": "TRENA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "509-924-2600"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "6011706837",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ID",
            "license": "P-224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Foot Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Foot Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Maries, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.