DR. DEREK A KHORSAND (NPI# 1598176448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598176448 |
| Entity Type | Individual |
| Full Name | DR. DEREK A KHORSAND |
| Credential | MD |
| Practice Address |
Kootenai Health 2003 Kootenai Way Coeur D'alene ID 83814 |
| Mailing Address |
Kootenai Outpatient Imaging 700 W Ironwood Dr, Suite 175 Coeur D'alene ID 83814 |
| Practice Telephone | 2086256361 |
| Mailing Telephone | 2086256300 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2020-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-15066 | ID | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
M-15066 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
KOOTENAI HEALTH 2003 KOOTENAI WAY |
| City | COEUR D'ALENE |
| State | ID |
| Zip Code | 83814 |
| 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 | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508224379 | Teton Vascular Institute of Pocatello A Series of Teton Group | Radiology | 444 Hospital Way Bldg 100, Ste 111, Pocatello, ID 83201-2745 | 2016-02-08 |
| 1851871172 | Russell L Evans | Radiology | 320 Warner Dr, Lewiston, ID 83501-4441 | 2018-08-16 |
| 1083842033 | Andrew Albert Peterson | Radiology | 190 E Bannock St, Boise, ID 83712-6241 | 2009-06-29 |
| 1154584712 | Gem State Radiology LLP | Radiology | 161 E Mallard Dr, Suite 130, Boise, ID 83706-3974 | 2008-07-03 |
| 1760682066 | Paul David Sonntag | Radiology | 190 E Bannock, Boise, ID 83712 | 2007-07-24 |
| 1629007844 | Idaho Vascular Institute Pllc | Radiology | 4400 E Flamingo Ave, Nampa, ID 83687-9203 | 2006-07-01 |
| 1386685535 | David Shelley | Radiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2006-06-09 |
| 1316913254 | John H Whiting Jr. | Radiology | 444 Hospital Way, Suite 701, Pocatello, ID 83201-2701 | 2006-02-28 |
| 1356329783 | David Reed Condie | Radiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2006-01-05 |
| 1023096955 | John W. Ho | Radiology | 415 6th St, Lewiston, ID 83501-2431 | 2005-12-30 |
| 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.