MICHELLE A GUPTA (NPI# 1033343298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033343298 |
| Entity Type | Individual |
| Full Name | MICHELLE A GUPTA |
| Other Name | MICHELLE A LIGHTFOOT |
| Credential | MD |
| Practice Address |
101 W 8th Ave Ste 100 Spokane WA 99204 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5094745489 |
| Practice Fax Number | 5092277070 |
| Mailing Telephone | 8667472455 |
| Mailing Fax Number | 5092277070 |
| Enumeration Date | 2009-05-03 |
| Last Update Date | 2020-06-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | N/A | CA | Allopathic & Osteopathic Physicians |
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
MD60857749 | WA | Allopathic & Osteopathic Physicians |
| N | 2088P0231X |
Urology Specialization: Pediatric Urology |
075711 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003177886A | 05 |
| Street Address |
101 W 8TH AVE STE 100 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336310945 | Nathaniel R Miller | Obstetrics & Gynecology | 101 W 8th Ave Ste 100, Spokane, WA 99204 | 2008-03-22 |
| 1962916601 | Elizabeth Primrose Phenneger | Nurse Practitioner | 101 W 8th Ave Ste 100, Spokane, WA 99204-2307 | 2017-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447576137 | Providence Physician Services Co | Urology | 315 W 9th Ave, Ste 200, Spokane, WA 99204-2501 | 2010-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669898201 | Kevin K. Gandhi, M.d., Pllc | Urology | 1530 S Union Ave Ste 5, Tacoma, WA 98405-1954 | 2014-03-06 |
| 1710184494 | Dimitri Kuznetsov, M.d. Pllc | Urology | 1274 7th St Ste B, Port Townsend, WA 98368-2404 | 2007-06-27 |
| 1992931281 | Jennifer Ahn | Urology | 4800 Sand Point Way Ne, Oa.9.220, Seattle, WA 98105-3901 | 2009-06-01 |
| 1356506331 | Jose Nicolas Fernandez Bonilla | Urology | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2008-07-19 |
| 1932302163 | Bertram Joseph Levy | Urology | 834 Sheridan St, Port Townsend, WA 98368-2443 | 2007-06-06 |
| 1194848317 | Kevin K Gandhi | Urology | 1530 S Union Ave, Suite 5, Tacoma, WA 98405-1954 | 2007-04-10 |
| 1417038779 | Thomas S. Lendvay | Urology | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-10-17 |
| 1467546796 | Martin A. Koyle | Urology | 4800 Sand Point Way Ne, Division of Urology W7729, Seattle, WA 98105-3901 | 2006-10-03 |
| 1912993320 | Mark P Cain | Urology | 1959 Ne Pacific St, Seattle, WA 98195-5128 | 2005-09-21 |
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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.