Venia, PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VENIA, PLLC

Practice address

2109 N Main St
Coeur D Alene, ID 83814-5768

Phone

(208) 676-0104

Fax

(208) 765-1893

NPI assigned

Jun 16, 2006

Organization subpart

No

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

Authorized official

Name

Douglas Stafford, MDNPI 1598767196

Title

President

Phone

(208) 676-0104

Specialties & licenses 1

Addresses

Other names 1

• Vein Clinics Northwest, PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

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

• Douglas R Stafford, M.D.

  • Vascular Surgery Physician
  • Coeur D Alene, ID
  • NPI 1598767196
  Medicare reassignment NPD Authorized official
• David Charles King, MD

  • Occupational Medicine Physician
  • Post Falls, ID
  • NPI 1043204100
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1841234069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3482",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838773482",
            "telephone_number": "208-676-0104",
            "fax_number": "208-765-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 N MAIN ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838145768",
            "telephone_number": "208-676-0104",
            "fax_number": "208-765-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-676-0104",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vein Clinics Northwest, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Zachary Lee Vaughan, LCSW
• Adam David Vaughn
• Glenn Vaughn, LCPC
• Roxanne Lynette Vaughn, LMSW
• Jack A Venbrux, M.A., LCPC, LMHC
• Jean Vergilio
• Ginger Lynn Verhaag, LPC
• Cassie Nacoll Verlanic, MSPED
• Tana Lynn Vesser, FNP
• Katiuska A Vestman, PMHNP

• Vascular Surgery Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Vascular Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.