Northwest Renal SVC Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

NORTHWEST RENAL SVC INC

Practice address

801 W 5TH Ave
Suite 509
Spokane, WA 99204

Phone

(509) 744-1500

Fax

(509) 626-5460

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Leo Eugene Obermiller Jr., MDNPI 1528159316

Title

President

Phone

(509) 744-1500

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leo Eugene Obermiller Jr., MD

  • Nephrology Physician
  • Spokane, WA
  • NPI 1528159316
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801987797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W 5TH AVE",
            "address_2": "SUITE 509",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99204",
            "telephone_number": "509-744-1500",
            "fax_number": "509-626-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W 5TH AVE",
            "address_2": "SUITE 509",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99204",
            "telephone_number": "509-744-1500",
            "fax_number": "509-626-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST RENAL SVC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OBERMILLER",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-744-1500",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1109102",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7098122",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Physical Therapy and Spine Rehabilitation Inc
• Northwest Physical Therapy Center
• Northwest Pulmonary
• Northwest Reflections PLLC
• Northwest Renal Services Inc
• Northwest Sexual Counseling
• Northwest Speech Services PLLC
• Northwest Spine and Pain Medicine, PLLC
• Northwest Spokane Pediatrics, PLLC
• Northwest Sports and Exercise Medicine

• Nephrology Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Nephrology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.