Spokane Surgery Center LTD PS

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SPOKANE SURGERY CENTER LTD PS

Practice address

12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133

Phone

(509) 928-1990

Fax

(509) 928-2933

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stewart Pugmire Brim, DPMNPI 1730297573

Title

Owner President

Phone

(509) 928-1990

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Listed as

Spokane Surgery Center LTD PSCCN 50C0001020

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

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

• Stewart Pugmire Brim, DPM

  • Podiatrist
  • Spokane Valley, WA
  • NPI 1730297573
  NPD (past) Authorized official

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1902864879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE C",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-928-1990",
            "fax_number": "509-928-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE C",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-928-1990",
            "fax_number": "509-928-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE SURGERY CENTER LTD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "BRIM",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "PUGMIRE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "509-928-1990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7087760",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490000540",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "117682",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spokane Podiatry PS
• Spokane Podiatry PS
• Spokane River Birth Center
• Spokane River Family Wellness PLLC
• Spokane Sinal Decompression Center PS
• Spokane Urology PLLC
• Spokane Valley Al, LLC
• Spokane Valley Chiropractic Center,P.L.L.C.
• Spokane Valley Dental
• Spokane Valley Ear Nose & Throat PS

• Ambulatory Surgical Clinic/Center in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.