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NORTH IDAHO IMAGING CENTER NPI 1457353450


NPI Information

NPI: 1457353450
Provider Name: NORTH IDAHO IMAGING CENTER

Doing Business As: KOOTENAI OUTPATIENT IMAGING

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
700 W IRONWOOD DR
SUITE 110
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 666-3200
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NORTH IDAHO IMAGING CENTER is a diagnostic radiology radiology in Coeur D Alene, ID. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. NORTH IDAHO IMAGING CENTER NPI is 1457353450. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Kootenai Outpatient Imaging.

The provider's business location address is:

700 W IRONWOOD DR
SUITE 110
COEUR D ALENE, ID
ZIP 83814-656
Phone: (208) 666-3200
Fax: (208) 666-3217

The provider's authorized official is Thomas J Legel .
The authorized official title is Delegated Official and has the following contact phone number (208) 666-3200.

The enumeration date for this NPI number is 8/10/2005 and was last updated on 12/21/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17058530MEDICAIDWASHINGTON
21374163MEDICARE ID-TYPE UNSPECIFIEDIDAHOCIGNA MEDICARE - GROUP #
3002735600MEDICAIDIDAHO
4CR0440OTHERIDAHORR MEDICARE
586371OTHERIDAHOBC ID - CDA
68J422OTHERIDAHOBC ID - PF

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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