NPIMap

Organization Active NPI

Vannvei LLC

  • Multi-Specialty Clinic/Center
  • Lewiston, ID
National Provider Identifier
1881200517
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
VANNVEI LLC
Practice address
1522 17TH St
Lewiston, ID 83501-3652
Phone
(208) 743-8416
NPI assigned
Sep 18, 2020
Last updated
Nov 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Authorized official

Name
Ms. Teresa Gall
Title
Controller
Phone
(509) 758-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1522 17TH St
Lewiston, ID 83501-3652

Mailing address

PO Box 341
Lewiston, ID 83501-0341

Other practice location 1

1221 Highland Ave
Clarkston, WA 99403-2829
Phone (509) 758-3311

Other practice location 2

2841 Juniper Dr # 2
Lewiston, ID 83501-4719
Phone (208) 848-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201211000338 ID Part B Supplier - Clinic/Group Practice 1254743420 Receives reassigned benefits from 31 practitioners
Practice locations: Lewiston, ID
O20210112002739 WA Part A Provider - End-Stage Renal Disease Facility (ESRD) 1254743420 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clarkston, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Vannvei LLC
    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Clarkston, WA
    • NPI 1124186804

    1254743420

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1881200517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 341",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835010341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 17TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013652",
            "telephone_number": "208-743-8416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "WA",
            "postal_code": "994032829",
            "country_code": "US",
            "telephone_number": "509-758-3311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2841 Juniper Dr # 2",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835014719",
            "country_code": "US",
            "telephone_number": "208-848-9001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VANNVEI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "509-758-5511",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.