North Idaho Urology, PLLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

M-3632 Issued in ID

Legal business name

NORTH IDAHO UROLOGY, PLLC

Practice address

980 W Ironwood Dr
Ste. 104
Coeur D Alene, ID 83814-2668

Phone

(208) 667-0621

Fax

(208) 664-1709

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Christine A Chatfield

Title

Billing Supervisor

Phone

(208) 667-0621

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

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

• Randil L Clark, M.D.

  • Urology Physician
  • Coeur D' Alene, ID
  • NPI 1205961182
  Medicare reassignment Care Compare group NPD
• Edward D Ellison, M.D.

  • Urology Physician
  • Coeur D' Alene, ID
  • NPI 1346375235
  Medicare reassignment Care Compare group NPD
• David Flores, M.D.

  • Urology Physician
  • Coeur D Alene, ID
  • NPI 1972892669
  Medicare reassignment Care Compare group NPD
• Roxanne Haslam, MD

  • Urology Physician
  • Coeur D Alene, ID
  • NPI 1205368198
  Medicare reassignment Care Compare group NPD
• Matthew David McLaughlin, D.O.

  • Urology Physician
  • Coeur D Alene, ID
  • NPI 1215071469
  Medicare reassignment Care Compare group NPD
• Chad Allan Peterson, M.D.

  • Urology Physician
  • Coeur D Alene, ID
  • NPI 1629284732
  Medicare reassignment Care Compare group NPD
• Jessica A Adams, PA-C

  • Medical Physician Assistant
  • Coeur D Alene, ID
  • NPI 1770890444
  Medicare reassignment Care Compare group
• Reagan Emily Snow

  • Medical Physician Assistant
  • Coeur D Alene, ID
  • NPI 1265100861
  Medicare reassignment Care Compare group
• Richard Lee Wiesemann II

  • Medical Physician Assistant
  • Coeur D Alene, ID
  • NPI 1629220488
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1891834768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR",
            "address_2": "STE 104",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-667-0621",
            "fax_number": "208-664-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR",
            "address_2": "STE. 104",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-667-0621",
            "fax_number": "208-664-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO UROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "CHATFIELD",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "208-667-0621"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "ID",
            "license": "M-3632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002667200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002507200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805898101",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.