MR. JUSTIN DAVID OVERHOFF (NPI# 1508331836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508331836 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN DAVID OVERHOFF |
| Credential | PA-C |
| Practice Address |
980 W Ironwood Dr Ste 104 Coeur D Alene ID 83814-2668 |
| Practice Telephone | 2086640621 |
| Practice Fax Number | 2086641709 |
| Mailing Telephone | 2086670621 |
| Mailing Fax Number | 2086641709 |
| Enumeration Date | 2018-10-13 |
| Last Update Date | 2020-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
60899059 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
980 W IRONWOOD DR STE 104 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972892669 | David Flores | Urology | 980 W Ironwood Dr Ste 104, Coeur D Alene, ID 83814-2668 | 2011-04-04 |
| 1700427796 | Colin Beacom | Physician Assistant | 980 W Ironwood Dr Ste 104, Coeur D Alene, ID 83814-2668 | 2019-10-01 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023118122 | Heather Sarkis | Physician Assistant | 315 W Dalton Ave, Coeur D Alene, ID 83815-8600 | 2006-09-25 |
| 1841248929 | Stuart T Sharp | Physician Assistant | 2003 Kootenai Health Way Ste 300, Coeur D Alene, ID 83814-6051 | 2006-05-04 |
| 1861484701 | Amanda L Fiola | Physician Assistant | 700 W Ironwood Dr Ste 375, Coeur D Alene, ID 83814-4401 | 2005-08-17 |
| 1407307259 | Nathan Wheatley | Physician Assistant | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2016-10-17 |
| 1841748530 | Elizabeth St John | Physician Assistant | 700 W Ironwood Dr, Ste 341, Coeur D Alene, ID 83814-2656 | 2016-09-12 |
| 1235521279 | Cody Reese | Physician Assistant | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2015-02-27 |
| 1932503596 | Alison Naomi Wheatley | Physician Assistant | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2014-10-10 |
| 1437553187 | Gretchen Foley | Physician Assistant | 700 W Ironwood Dr, 320, Coeur D Alene, ID 83814-2656 | 2014-10-09 |
| 1891123543 | Henry Petersen | Physician Assistant | 700 W Ironwood Dr, Ste 320, Coeur D Alene, ID 83814-2656 | 2013-10-16 |
| 1174961288 | Melissa C Burns-price | Physician Assistant | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2013-06-11 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on MR. JUSTIN DAVID OVERHOFF.
| 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.