KOOTENAI URGENT CARE LLC (NPI# 1629392154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629392154 |
| Entity Type | Organization |
| Organization Name | KOOTENAI URGENT CARE LLC |
| Practice Address |
1300 E Mullan Ave Suite 600 Post Falls ID 83854-6052 |
| Mailing Address |
700 W Ironwood Dr Suite 272e Coeur D Alene ID 83814-2656 |
| Practice Telephone | 2087779110 |
| Practice Fax Number | 2087771871 |
| Mailing Telephone | 2086760145 |
| Mailing Fax Number | 2086760147 |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2012-03-22 |
| Authorized Official Name | ERIC KOELSCH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2086760145 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MEDICARE PART B PTAN | 1369049 | 01 |
| ID | RAILROAD MEDICARE | DQ3168 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407172059 | Kootenai Urgent Care LLC | Physician Assistant | 566 W Prairie Ave, Coeur D Alene, ID 83815-7766 | 2010-04-07 |
| 1821312356 | Kootenai Urgent Care LLC | Physician Assistant | 700 W Ironwood Dr, Suite 170e, Coeur D Alene, ID 83814-2656 | 2010-03-26 |
| Street Address |
1300 E MULLAN AVE SUITE 600 |
| City | POST FALLS |
| State | ID |
| Zip Code | 83854-6052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437103009 | Holly J Bassler | Family Medicine | 1300 E Mullan Ave, Ste 1300, Post Falls, ID 83854-6052 | 2006-05-19 |
| 1669546388 | North Idaho Family Physicians, LLC | Family Medicine | 1300 E Mullan Ave, Suite 600, Post Falls, ID 83854-6052 | 2006-11-17 |
| 1821100637 | Inland Northwest Renal Care Group, LLC | Clinic/Center | 1300 E Mullan Ave, Suite 1200, Post Falls, ID 83854-6052 | 2006-08-31 |
| 1528178472 | Donald Blair Lindblad | Family Medicine | 1300 E Mullan Ave, 1300, Post Falls, ID 83854-6052 | 2006-08-30 |
| 1912928136 | Faine Stenhouse | Family Medicine | 1300 E Mullan Ave, 1300, Post Falls, ID 83854-6052 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264032 | Esteem Counseling, LLC | Counselor | 1404 North Marcasite Court, Post Falls, ID 83854 | 2020-08-07 |
| 1497376685 | Teresa Marie Ragan | Registered Nurse | 1551 E Mullan Ave Bldg A, Ste 200b, Post Falls, ID 83854 | 2020-04-29 |
| 1245792910 | Samantha Patricia Bourassa | Specialist/Technologist | 2832 E Poleline Ave, Post Falls, ID 83854 | 2019-04-02 |
| 1003392598 | Joshua Welz | Psychologist | 3211 N Guinness Ln Apt 201, Post Falls, ID 83854 | 2018-07-17 |
| 1639608094 | Anthony Leodis Walls Jr. | Specialist/Technologist | 8732 N Meyer Rd, Post Falls, ID 83854 | 2017-06-08 |
| 1831635911 | Glenda Felts | Social Worker | 8561 N Cloverleaf Rd, # 22, Hauser, ID 83854 | 2017-01-12 |
| 1144763467 | Rachel M. Pope | Behavioral Analyst | 204 E 1st Ave Apt 4, Post Falls, ID 83854 | 2016-11-18 |
| 1871960393 | Randy Robinson | Massage Therapist | 2525 E Seltice Way Ste C, Post Falls, ID 83854 | 2015-09-01 |
| 1194112375 | James Bailey | Family Medicine | 185 W 4th Ave Ste B, Post Falls, ID 83854 | 2015-04-24 |
| 1033534953 | Lauren Tandy | Speech-Language Pathologist | 398 S. Corbin Rd., Post Falls, ID 83854 | 2014-02-28 |
| Find all providers in zip 83854 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194112375 | James Bailey | Family Medicine | 185 W 4th Ave Ste B, Post Falls, ID 83854 | 2015-04-24 |
| 1619381852 | David William Glenn | Family Medicine | 1300 E Mullan Ave Ste 1300, Post Falls, ID 83854-6057 | 2014-06-16 |
| 1346505807 | Howard Martin Hochberg | Family Medicine | 1712 Bobwhite Lane, Post Falls, ID 83854-4942 | 2012-07-11 |
| 1891019493 | Shaun Brancheau | Family Medicine | 925 E. Polston Ave., Post Falls, ID 83854 | 2010-03-25 |
| 1427102938 | Cher A Jacobsen | Family Medicine | 185 W 4th Avenue, Suite B, Post Falls, ID 83854-4979 | 2007-01-22 |
| 1659476844 | Michael L Oglesbay | Family Medicine | 1110 E Polston Ave Ste 1, Post Falls, ID 83854-6139 | 2006-09-13 |
| 1548200181 | Family Health Care of Post Falls, Pllc | Family Medicine | 1110 Polston Ave, Ste 1, Post Falls, ID 83854 | 2006-06-08 |
| 1437103009 | Holly J Bassler | Family Medicine | 1300 E Mullan Ave, Ste 1300, Post Falls, ID 83854-6052 | 2006-05-19 |
| 1093768707 | Leanne M Rousseau | Family Medicine | 925 E Polston Ave, Post Falls, ID 83854-9049 | 2006-05-17 |
| 1942298054 | Michael W Monohan I | Family Medicine | 1220 E. Polston Ave, Post Falls, ID 83854 | 2005-10-12 |
| Find all providers in POST FALLS | ||||
| City | POST FALLS |
| Zip Code | 83854 |
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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.