MR. PETER JOHN LEICHTNAM (NPI# 1164072187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164072187 |
Entity Type | Individual |
Full Name | MR. PETER JOHN LEICHTNAM |
Practice Address |
1200 W Ironwood Dr Ste 309 Coeur D Alene ID 83814-2660 |
Practice Telephone | 5099942105 |
Mailing Telephone | 5099942105 |
Enumeration Date | 2019-09-12 |
Last Update Date | 2019-09-12 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | ID | Ambulatory Health Care Facilities |
Address | Telephone Number | Fax Number |
---|---|---|
10905 E Montgomery Dr Ste 4, Spokane Valley, WA 992066606 | 5099942105 | 5098926924 |
1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 838142660 | 5099942105 |
Street Address |
1200 W IRONWOOD DR STE 309 |
City | COEUR D ALENE |
State | ID |
Zip Code | 83814-2660 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952951329 | American Mobile Drug Testing / A Drug Free Alliance | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
Find all providers in zip 83814 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
1760684153 | North Star Child Development Center | Clinic/Center | 1583 W Dalton Ave, Coeur D Alene, ID 83815-8962 | 2007-06-05 |
1316574700 | Coeur Vitality Pllc | Clinic/Center | 110 E Wallace Ave, Coeur D Alene, ID 83814-2948 | 2020-03-25 |
1952951329 | American Mobile Drug Testing / A Drug Free Alliance | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-17 |
1366099236 | Avalon Counseling, LLC | Clinic/Center | 1250 W Ironwood Dr Ste 303, Coeur D Alene, ID 83814-2682 | 2019-08-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992323216 | Wolf Pack LLC | Clinic/Center | 939 S 25th E Ste 115, Ammon, ID 83406-5736 | 2020-07-13 |
1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
1104316785 | Pend Oreille Vision Care | Clinic/Center | 6132 Highway 2, Priest River, ID 83856 | 2018-05-18 |
1114432689 | Triton Elite Athletic Medicine | Clinic/Center | 2392 E Gowen Rd, Boise, ID 83716-6707 | 2017-12-06 |
Find all providers with the same taxonomy |
City | COEUR D ALENE |
Zip Code | 83814 |
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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.