NPIMap

Organization Active NPI

Mobile Medical Clinic Chess Inc

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1871558403
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOBILE MEDICAL CLINIC CHESS INC
Practice address
922 S Cowley St
Suite 6
Spokane, WA 99202-1263
Phone
(509) 220-3048
Fax
(509) 279-0286
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tawny B Miles
Title
Vice President/Admin Director
Phone
(509) 220-3048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

922 S Cowley St
Suite 6
Spokane, WA 99202-1263

Mailing address

922 S Cowley St
Suite 6
Spokane, WA 99202-1263
Phone (509) 220-3048

Other identifiers 3

IdentifierTypeStateIssuer
7127715MedicaidWA
300815300815OtherWAPREMERA BLUE CROSS PROV #
P00260800OtherWAPALMETTO GBA-RAILROAD MED

National Provider Directory

National Provider Directory

Locations

922 S Cowley St
Ste 6
Spokane, WA 99202
Phone (509) 220-3048

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871558403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 S COWLEY ST",
            "address_2": "SUITE 6",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021263",
            "telephone_number": "509-220-3048",
            "fax_number": "509-279-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 S COWLEY ST",
            "address_2": "SUITE 6",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021263",
            "telephone_number": "509-220-3048",
            "fax_number": "509-279-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL CLINIC CHESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "TAWNY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT/ADMIN DIRECTOR",
        "authorized_official_telephone_number": "509-220-3048",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7127715",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS PROV #",
            "identifier": "300815300815",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD MED",
            "identifier": "P00260800",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.