DR. EDWARD D ELLISON (NPI# 1346375235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346375235 |
| Entity Type | Individual |
| Full Name | DR. EDWARD D ELLISON |
| Credential | M.D. |
| Practice Address |
980 Ironwood Dr W Ste 104 Coeur D' Alene ID 83814 |
| Practice Telephone | 2086670621 |
| Practice Fax Number | 2086641709 |
| Mailing Telephone | 2086670621 |
| Mailing Fax Number | 2086641709 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2012-05-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | M-8020 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805898101 | 05 |
| Street Address |
980 IRONWOOD DR W STE 104 |
| City | COEUR D' ALENE |
| State | ID |
| Zip Code | 83814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205961182 | Randil L Clark | Urology | 980 Ironwood Dr W, Ste 104, Coeur D' Alene, ID 83814 | 2007-02-22 |
| 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 | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215062294 | Charles L Gates Jr. | Urology | 980 W. Ironwood Dr., Ste. 104, Coeur D' Alene, ID 83814 | 2007-02-22 |
| 1205961182 | Randil L Clark | Urology | 980 Ironwood Dr W, Ste 104, Coeur D' Alene, ID 83814 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699242123 | Treasure Valley Urology Pllc | Urology | 3090 E Gentry Way Ste 220, Meridian, ID 83642-3550 | 2018-11-02 |
| 1154682565 | Richard Alan Blatter | Urology | 2001 S Woodruff Ave Ste 4, Idaho Falls, ID 83404-6371 | 2012-06-01 |
| 1750648002 | Jason Orien | Urology | 777 Hospital Way Ste 215, Pocatello, ID 83201-5175 | 2012-04-11 |
| 1972892669 | David Flores | Urology | 980 W Ironwood Dr Ste 104, Coeur D Alene, ID 83814-2668 | 2011-04-04 |
| 1346407921 | Helen Jia-ru Kuo | Urology | 2855 E. Magic View Drive, Meridian, ID 83642 | 2008-05-21 |
| 1144344391 | Robert W. Bohus, M.d., F.a.c.s. | Urology | 500 S 11th Ave Ste 301, Pocatello, ID 83201-4879 | 2007-03-16 |
| 1316028889 | Edwin Manley Briggs | Urology | 1316 Harrison Blvd, Boise, ID 83702-3444 | 2006-10-18 |
| 1710097068 | Jared G Heiner | Urology | 3085 E Magic View Dr Ste 140, Meridian, ID 83642-3745 | 2006-08-30 |
| 1033121322 | Timothy Osborn Taylor | Urology | 2330 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-13 |
| 1689617722 | A P Mclaughlin IIi Apc | Urology | 120 N Leadville, Ketchum, ID 83340 | 2006-06-14 |
| 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.