Organization Active NPI

PMR Healthcare

  • Primary Care Clinic/Center
  • Coeur d'Alene, ID
National Provider Identifier
1902660863
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PMR HEALTHCARE
Practice address
920 W Ironwood Dr Ste 206
Coeur D Alene, ID 83814-2643
Phone
(317) 845-5974
NPI assigned
Feb 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Joseph David Donadio, EMT-P
Title
Vice President of Operations
Phone
(317) 845-5974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

920 W Ironwood Dr Ste 206
Coeur D Alene, ID 83814-2643

Mailing address

7399 N Shadeland Ave # 103
Indianapolis, IN 46250-2052

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2299885PMR Healthcare - Kootenai County Clinic920 W Ironwood Dr Ste 206, Coeur D'Alene, ID 83814Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
PMR Healthcare6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

920 W Ironwood Dr
Ste 206
Coeur D Alene, ID 83814
Phone (317) 845-5974

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1902660863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7399 N SHADELAND AVE # 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W IRONWOOD DR STE 206",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142643",
            "telephone_number": "317-845-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMR HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "DONADIO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "317-845-5974",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.