PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1487971149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487971149 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PPS PSHMC MATERNAL FETAL MEDICINE |
| Practice Address |
101 W 8th Ave Ste 1100 Spokane WI 99204-2307 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5094744060 |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2011-02-28 |
| Authorized Official Name | ANSELMO NUNEZ (CFO) |
| Authorized Official Telephone | 5094746616 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PPS PSHMC MATERNAL FETAL MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740566173 | Providence Physician Services Co | Internal Medicine | 212 Central Ave Suite 440, Spokane, WA 99208 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1184915829 | Providence Physician Services Co | Family Medicine | 5011 W. Lowell Ave, Seattle, WA 99208-8587 | 2011-04-28 |
| 1578869913 | Providence Physician Services Co | Family Medicine | 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 | 2011-02-02 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1245557917 | Providence Physician Services Co | Obstetrics & Gynecology | 518 Clay Street, Chewelah, WA 99109 | 2010-04-21 |
| 1215223953 | Providence Physician Services Co | Prosthetic/Orthotic Supplier | 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 | 2011-06-21 |
| 1336433812 | Providence Physician Services Co | Family Medicine | 104 W 5th Ave, Suite 390e, Spokane, WA 99204 | 2011-06-02 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
101 W 8TH AVE STE 1100 |
| City | SPOKANE |
| State | WI |
| Zip Code | 99204-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819319 | Sacred Heart Medical Center | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2005-05-31 |
| 1124626841 | Melissa Ann Benson | Respiratory Therapist, Registered | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-10-14 |
| 1184236671 | Margaret Ann Warren | Physical Therapist | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-08-18 |
| 1265044747 | Melyssa Carlson | Registered Nurse | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-08-17 |
| 1760091276 | Corle Morefield | Pharmacist | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-07-30 |
| 1174143663 | Ashley Kay Gardiner | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-24 |
| 1265061485 | Mary Katherine Griessmann | Social Worker | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-08 |
| 1558990994 | Ingrid Mary Agnew | Social Worker | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-07 |
| 1952930562 | Cody Key | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-06 |
| 1417586173 | Samuel Logan | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457417263 | Ehs Womens and Childrens Services LLC | Obstetrics & Gynecology | 800 W 5th Ave, Spokane, WA 99204-2803 | 2006-12-28 |
| 1619927571 | Reinaldo Acosta | Obstetrics & Gynecology | 910 W 5th Ave, Suite 380, Spokane, WA 99204 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336431139 | Geoffrey Howard Gordon | Obstetrics & Gynecology | 737 Apollo Way, Madison, WI 53718-2913 | 2011-05-11 |
| 1417982448 | John Sargent Sholl | Obstetrics & Gynecology | 2133 To To Tom Dr, Lac Du Flambeau, WI 54538-9661 | 2006-07-11 |
| 1548218886 | Chanel T Tyler | Obstetrics & Gynecology | 7021 Colony Dr, Madison, WI 53717-1407 | 2006-05-05 |
| 1811966211 | Dinesh M Shah | Obstetrics & Gynecology | 117 S Hamilton St Apt 807, Madison, WI 53703-4415 | 2006-03-16 |
| 1811996796 | Marilynn E Frederiksen | Obstetrics & Gynecology | 945 N 12th St, Milwaukee, WI 53233-1305 | 2005-07-21 |
| 1811330376 | Jacquelyn Hanna Adams | Obstetrics & Gynecology | 202 S Park St, Madison, WI 53715-1507 | 2013-04-15 |
| 1164764874 | Rachel Katherine Harrison | Obstetrics & Gynecology | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2013-03-20 |
| 1437409752 | Fox Valley Perinatology, S.c. | Obstetrics & Gynecology | 1818 N Meade St, Appleton, WI 54911-3454 | 2012-09-13 |
| 1336431287 | Emily Rose Smith | Obstetrics & Gynecology | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2011-05-11 |
| 1912297102 | Kathleen Antony | Obstetrics & Gynecology | 202 S Park St, Madison, WI 53715-1507 | 2011-04-09 |
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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.