Individual provider Active NPI

Mark J Erwin, PA-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1881693919
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004364 Issued in WA
Practice address
5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone
(509) 252-6336
Fax
(509) 252-6337
NPI assigned
Jul 20, 2005
Last updated
Mar 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004364 WA Primary

Addresses

Primary practice location

5633 N Lidgerwood St
Spokane, WA 99208-1224

Mailing address

9631 N Nevada St
Ste 210
Spokane, WA 99218-1197
Phone (509) 319-2431

Other identifiers 1

IdentifierTypeStateIssuer
8331779MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of California, Inc. Past Accepting new patients
Prevention NW Past Accepting new patients
E.a. Sohn Inc., P.S. PastSince Jan 1, 2003 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1881693919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 N NEVADA ST",
            "address_2": "STE 210",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181197",
            "telephone_number": "509-319-2431",
            "fax_number": "877-568-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224",
            "telephone_number": "509-252-6336",
            "fax_number": "509-252-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8331779",
            "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 Mar 30, 2016; 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.