ANDREW ANTHONY HENNEBERG (NPI# 1689603847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689603847 |
| Entity Type | Individual |
| Full Name | ANDREW ANTHONY HENNEBERG |
| Credential | MD |
| Practice Address |
980 W Ironwood Dr Suite 201 Coeur D Alene ID 83814 |
| Practice Telephone | 2087654888 |
| Practice Fax Number | 2086678618 |
| Mailing Telephone | 2087654888 |
| Mailing Fax Number | 2086678618 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | M-9485 | ID | Other Service Providers |
| Y | 207V00000X | Obstetrics & Gynecology | M-9485 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807438700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 980 W Ironwood Dr, Suite 304, Coeur D Alene, ID 83814 | 2087654888 | 2086678618 |
| Street Address |
980 W IRONWOOD DR SUITE 201 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477552008 | Jean Marie Prince | Pediatrics | 980 W Ironwood Dr, Ste 302, Coeur D Alene, ID 83814-2604 | 2005-07-15 |
| 1538619630 | Breanne Huss | Advanced Practice Midwife | 980 W Ironwood Dr, Ste 306, Coeur D Alene, ID 83814-2668 | 2016-10-12 |
| 1760708044 | Faith Marie Krull | Midwife | 980 W Ironwood Dr, Suite 306, Coeur D Alene, ID 83814-2668 | 2010-04-13 |
| 1417270158 | Christy L Riley | Pediatrics | 980 W Ironwood Dr, Suite 302, Coeur D Alene, ID 83814-2668 | 2010-03-09 |
| 1114161551 | Marston T Westbrook, Dds, LLC | Dentist | 980 W Ironwood Dr, Suite 301, Coeur D Alene, ID 83814-2668 | 2009-04-29 |
| 1619110822 | Kevin Jay Schultz | Obstetrics & Gynecology | 980 W Ironwood Dr, Suite 304, Coeur D Alene, ID 83814-2668 | 2009-04-17 |
| 1851545628 | Kathyrn Ann Sumner Kelso | Counselor | 980 W Ironwood Dr, Suite 101, Coeur D Alene, ID 83814-2668 | 2008-11-06 |
| 1609029826 | Julie M. Meltzer | Obstetrics & Gynecology | 980 W Ironwood Dr, 306, Coeur D Alene, ID 83814-2668 | 2008-10-31 |
| 1518123660 | Katie Renee' Knapp | Massage Therapist | 980 W Ironwood Dr, Ste 101, Coeur D Alene, ID 83814-2668 | 2008-07-29 |
| 1255509410 | Apple Family Care Pllc | Family Medicine | 980 W Ironwood Dr, Suite 201, Coeur D Alene, ID 83814-2668 | 2008-02-11 |
| Find all providers in the same location | ||||
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 |
|---|---|---|---|---|
| 1972547255 | Coeur D'alene Ob/gyn, Pa | Obstetrics & Gynecology | 2190a Ironwood Pl, Coeur D Alene, ID 83814-2610 | 2006-06-16 |
| 1588620751 | Steven K Woods | Obstetrics & Gynecology | 980 W Ironwood Dr Ste 306, Coeur D Alene, ID 83814-2668 | 2006-04-25 |
| 1275977399 | Jennifer Anne Farwell | Obstetrics & Gynecology | 980 W Ironwood Dr Ste 201, Coeur D Alene, ID 83814-2668 | 2013-04-19 |
| 1619110822 | Kevin Jay Schultz | Obstetrics & Gynecology | 980 W Ironwood Dr, Suite 304, Coeur D Alene, ID 83814-2668 | 2009-04-17 |
| 1609029826 | Julie M. Meltzer | Obstetrics & Gynecology | 980 W Ironwood Dr, 306, Coeur D Alene, ID 83814-2668 | 2008-10-31 |
| 1437305802 | Brenna Kolokoff Mccrummen | Obstetrics & Gynecology | 980 W Ironwood Dr Ste 306, Coeur D Alene, ID 83814-2668 | 2008-08-17 |
| 1013183532 | Nathan Paul Meltzer | Obstetrics & Gynecology | 980 W Ironwood Dr Ste 306, Coeur D Alene, ID 83814-2668 | 2008-05-05 |
| 1679616957 | Regan R Hill | Obstetrics & Gynecology | 980 W Ironwood Dr, Suite 306, Coeur D Alene, ID 83814-2668 | 2007-02-15 |
| 1649358268 | Womens Clinic of North Idaho | Obstetrics & Gynecology | 980 W Ironwood Drive, Suite 306, Coeur D Alene, ID 83814-2601 | 2006-11-01 |
| 1891717088 | John J Kim | Obstetrics & Gynecology | 980 W Ironwood Dr, Suite 304, Coeur D Alene, ID 83814-2668 | 2006-07-24 |
| Find all providers in COEUR D ALENE | ||||
| 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.