Deborah Ann Icenogle, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00028918 Issued in WA

Practice address

5011 W Lowell Ave Ste 100
Spokane, WA 99208-8587

Phone

(509) 299-1958

Fax

(509) 299-1070

NPI assigned

Sep 20, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: dicenogle219540@wm.providencedirect.org

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831296177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-385-0610",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 W LOWELL AVE STE 100",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992088587",
            "telephone_number": "509-299-1958",
            "fax_number": "509-299-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICENOGLE",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00028918",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD00028918",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1120765",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Isidro Ibarra, M.D.
• John M Ibarra
• Mirabel Ibe
• Icard, P.L.L.C.
• Alexis Ice, COTA/L
• Elizabeth Icenogle, D.M.D.
• Ideal Option, PLLC
• Ideal Option, PLLC
• Ideal Option, PLLC
• Nora Ifft, LAT, ATC

• Pediatrics Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Pediatrics 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.