NPIMap

Organization Active NPI

Minimally Invasive Surgery Northwest, Inc

  • Surgery Physician
  • Post Falls, ID
National Provider Identifier
1992758403
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MINIMALLY INVASIVE SURGERY NORTHWEST, INC
Practice address
750 N Syringa St
Suite 205
Post Falls, ID 83854-5275
Phone
(208) 415-0151
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Authorized official

Name
John L Pennings, M.D.
Title
President
Phone
(208) 415-0151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

750 N Syringa St
Suite 205
Post Falls, ID 83854-5275

Mailing address

750 N Syringa St
Suite 205
Post Falls, ID 83854-5275

Other identifiers 1

IdentifierTypeStateIssuer
CJ3341OtherIDRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

750 N Syringa St
Ste 205
Post Falls, ID 83854
Phone (208) 262-0945

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1992758403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST",
            "address_2": "SUITE 205",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST",
            "address_2": "SUITE 205",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275",
            "telephone_number": "208-415-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE SURGERY NORTHWEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "PENNINGS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-415-0151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ3341",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.