NPIMap

Organization Active NPI

Radiology Associates of North Idaho, PA

Doing business as Kootenai Imaging

  • Radiology Clinic/Center
  • Coeur d'Alene, ID
National Provider Identifier
1851384416
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
RADIOLOGY ASSOCIATES OF NORTH IDAHO, PA
Doing business as
Kootenai Imaging
Practice address
700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401
Phone
(208) 625-6309
Fax
(208) 625-6310
NPI assigned
Aug 29, 2005
Last updated
Feb 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Mr. Scott Venera
Title
Practice Manager
Phone
(208) 625-6309

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X
Multi-Specialty Clinic/Center 261QM1300X
Radiology Clinic/Center 261QR0200X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Mailing address

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401
Phone (208) 625-6309

Other names 1

  • Kootenai Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA, NY, NV, CA, CO, LA, AK8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20040520000648 ID Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 28 practitioners
Practice locations: Coeur D Alene, ID; Post Falls, ID
O20220202001523 WA Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 3 practitioners
Practice locations: Issaquah, WA; Seattle, WA; Spokane, WA
O20230222000226 NY Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY
O20231026003710 NV Part B Supplier - Clinic/Group Practice 4385635150 Practice locations: Reno, NV
O20240710003538 CA Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 2 practitioners
Practice locations: Encinitas, CA
O20250128001399 CO Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 2 practitioners
Practice locations: Denver, CO
O20251003000507 LA Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 1 practitioner
Practice locations: New Orleans, LA
O20251125003219 AK Part B Supplier - Clinic/Group Practice 4385635150 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

700 W Ironwood Dr
Ste 175
Coeur D Alene, ID 83814
Phone (208) 625-6300

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1851384416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6309",
            "fax_number": "208-625-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6309",
            "fax_number": "208-625-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF NORTH IDAHO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "VENERA",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "208-625-6309",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kootenai Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.