Individual provider Active NPI

John N Klim, MD

  • Internal Medicine Physician
  • Colville, WA
National Provider Identifier
1962494831
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00028372 Issued in WA
Practice address
143 Garden Homes Drive
Northeaster Washington Medical Group
Colville, WA 99114-0000
Phone
(509) 684-3701
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00028372 WA Primary

Addresses

Primary practice location

143 Garden Homes Drive
Northeaster Washington Medical Group
Colville, WA 99114-0000

Mailing address

PO Box 3649
Spokane, WA 99220-3649
Phone (509) 838-2531

Other identifiers 1

IdentifierTypeStateIssuer
1036425MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000803 WA Practitioner - Internal Medicine 5991783623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Aug 1, 2013 Accepting new patients
Providence Health & Services Washington Internal Medicine CurrentSince Aug 1, 2013 Accepting new patients
Rockwood Clinic PS Internal Medicine Current Accepting new patients
Providence Health & Services - Wa Past Accepting new patients

Locations

143 Garden Homes Dr
Colville, WA 99114
Phone (509) 684-3701

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

982 E Columbia Ave
Colville, WA 99114
Phone (509) 684-2561

101 W 8th Ave
Fl 3
Spokane, WA 99204
Phone (509) 474-2277

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1962494831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649",
            "telephone_number": "509-838-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 GARDEN HOMES DRIVE",
            "address_2": "NORTHEASTER WASHINGTON MEDICAL GROUP",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991140000",
            "telephone_number": "509-684-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIM",
        "first_name": "JOHN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00028372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036425",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colville, WA

Sources for this page

Verify at the official NPI Registry.