TIMOTHY BOCK ICENOGLE (NPI# 1285683029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285683029 |
| Entity Type | Individual |
| Full Name | TIMOTHY BOCK ICENOGLE |
| Credential | MD |
| Practice Address |
3415 W Horizon Ave Spokane WA 99208-8493 |
| Practice Telephone | 5092201900 |
| Mailing Telephone | 5092201900 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2016-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204F00000X | Transplant Surgery | MD00026659 | WA | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD00026659 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1072495 | 05 | |
| MT | 3505645 | 05 | |
| ID | 3756900 | 05 |
| Street Address |
3415 W HORIZON AVE |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-8493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285188128 | Elizabeth Icenogle | Dentist | 3415 W Horizon Ave, Spokane, WA 99208-8493 | 2016-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497863773 | Kai A Ihnken | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 122 W 7th Ave Ste 110, Spokane, WA 99204-2301 | 2006-08-28 |
| 1801894811 | Leland G. Siwek | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 62 W 7th Ave Ste 110, Spokane, WA 99204-2321 | 2005-07-13 |
| 1750523577 | Alexi Matousek | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 62 W 7th Ave Ste 110, Spokane, WA 99204-2321 | 2009-03-25 |
| 1538311287 | Providence Health & Services-wa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 62 W 7th Ave Ste 110, Spokane, WA 99204-2321 | 2008-10-14 |
| 1386805539 | Matthew Donavon Forrester | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 62 W 7th Ave Ste 110, Spokane, WA 99204-2321 | 2008-06-20 |
| 1720245905 | Justin Reeves | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 62 W 7th Ave Ste 110, Spokane, WA 99204-2321 | 2008-05-16 |
| 1659558476 | Providence Health Care | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 122 W 7th Ave, Ste 330, Spokane, WA 99204-2349 | 2008-01-23 |
| 1902898331 | Theodore C Koutlas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 62 W 7th Ave Ste 110, Spokane, WA 99204-2321 | 2005-08-22 |
| 1114925161 | Donald Vernon Holbert | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 122 W 7th Ave, Ste 110, Spokane, WA 99204-2349 | 2005-07-13 |
| 1902804867 | Michael A Judd | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 122 W 7th Ave, Ste 110, Spokane, WA 99204-2349 | 2005-07-13 |
| Find all providers in SPOKANE | ||||
Please comment or provide details below to improve the information on TIMOTHY BOCK ICENOGLE.
| 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.