GRITMAN MEDICAL CENTER INC (NPI# 1013556596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013556596 |
| Entity Type | Organization |
| Organization Name | GRITMAN MEDICAL CENTER INC |
| Practice Address |
804 S Washington St Ste A Moscow ID 83843-3182 |
| Mailing Address |
700 S Main St Moscow ID 83843-3046 |
| Practice Telephone | 2088836700 |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |
| Authorized Official Name | DANIELLE LYNAS (CFO) |
| Authorized Official Telephone | 2088832220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Gritman Interventional Pain Management Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871708289 | Gritman Medical Center Inc | Day Training, Developmentally Disabled Services | 324 S Cleveland St, Moscow, ID 83843-3768 | 2007-05-11 |
| 1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
| 1932769700 | Gritman Medical Center Inc | Internal Medicine | 700 S Main St, Moscow, ID 83843-3046 | 2019-06-14 |
| 1235626474 | Gritman Medical Center Inc | Psychiatry & Neurology | 803 S Main St Ste 210, Moscow, ID 83843-2695 | 2018-04-13 |
| 1235680703 | Gritman Medical Center Inc | Internal Medicine | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2016-10-20 |
| 1477004828 | Gritman Medical Center Inc | General Practice | 412 S Main St, Troy, ID 83871 | 2016-10-20 |
| 1386041119 | Gritman Medical Center Inc | Skilled Nursing Facility | 700 S Main St, Moscow, ID 83843-3056 | 2014-11-21 |
| 1942567847 | Gritman Medical Center Inc | Physician Assistant | 412 S Main St, Troy, ID 83871-0415 | 2012-04-16 |
| 1750475380 | Gritman Medical Center Inc | Clinic/Center | 606 E Main St, Kendrick, ID 83537 | 2006-10-03 |
| 1619988144 | Gritman Medical Center Inc | General Acute Care Hospital | 700 S Main St, Moscow, ID 83843-3056 | 2006-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GRITMAN MEDICAL CENTER INC. | 700 S Main St, Moscow, ID 83843 |
| Street Address |
804 S WASHINGTON ST STE A |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-3182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023286424 | John Anthony Schirmer | Nurse Anesthetist, Certified Registered | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2008-02-19 |
| 1235680703 | Gritman Medical Center Inc | Internal Medicine | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2016-10-20 |
| 1790182590 | Gritman Medical Center Inc. | Clinic/Center | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2014-11-24 |
| 1558681502 | Dustin Paul Gill | Nurse Anesthetist, Certified Registered | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2010-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588832992 | Idaho Pain Medicine, LLP | Pain Medicine | 8950 W Emerald St Ste 168, Boise, ID 83704-8296 | 2008-02-19 |
| 1427273853 | Kimberly A Vorse Md PC | Pain Medicine | 380 Washington Ave Suite 201, Ketchum, ID 83340 | 2007-04-13 |
| 1760403893 | Craig G Flinders | Pain Medicine | 2841 Juniper Dr, Lewiston, ID 83501-4719 | 2006-07-22 |
| 1740238849 | Patrick Edward Farrell | Pain Medicine | 301 W Myrtle St, Boise, ID 83702-7656 | 2006-05-04 |
| 1508825456 | Shane A Maxwell | Pain Medicine | 3551 E Overland Rd, Meridian, ID 83642-6757 | 2006-03-20 |
| 1639657521 | Heather Mckenzie | Pain Medicine | 2177 W Ironwood Center Dr, Coeur D Alene, ID 83814 | 2018-08-01 |
| 1336519891 | Timothy E. Snell, Md, Pllc | Pain Medicine | 2240 E Center St, Pocatello, ID 83201-2600 | 2015-09-28 |
| 1477941672 | Beacon Pain Clinic | Pain Medicine | 115 W Main St, 102, Boise, ID 83702-7302 | 2014-12-23 |
| 1366849572 | Exodus Pain Clinic | Pain Medicine | 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 | 2014-12-03 |
| 1609191881 | Christian Becker | Pain Medicine | 2060 S Woodruff Ave, Idaho Falls, ID 83404-6396 | 2010-03-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.