COEUR OBSTETRICS AND GYNECOLOGY, PLLC (NPI# 1730280744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730280744 |
| Entity Type | Organization |
| Organization Name | COEUR OBSTETRICS AND GYNECOLOGY, PLLC |
| Other Organization Name | D. ANTHONY & R. RANDEL HENNEBERG, PTR'S |
| Practice Address |
980 W Ironwood Dr Ste 201 Coeur D Alene ID 83814-2668 |
| Mailing Address |
980 W Ironwood Dr. Suite 201 Coeur D' Alene ID 83814 |
| Practice Telephone | 2087654888 |
| Mailing Telephone | 2087654888 |
| Mailing Fax Number | 2086678618 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-05-14 |
| Authorized Official Name | DR. ANDREW ANTHONY HENNEBERG (OWNER/MD) |
| Authorized Official Telephone | 2087654888 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | M-9485 | ID | Other Service Providers |
| Other Name | Type Code |
|---|---|
| D. Anthony & R. Randel Henneberg, PTR's | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 980 W Ironwood Dr., Suite 304, Coeur D' Alene, ID 83814 | 2087654888 | 2086678618 |
| Street Address |
980 W IRONWOOD DR STE 201 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699879072 | Dana L Colbert | Family Medicine | 980 W Ironwood Dr Ste 201, Coeur D Alene, ID 83814-2668 | 2006-09-07 |
| 1720564966 | Sarah Ferguson Kohal | Midwife | 980 W Ironwood Dr Ste 201, Coeur D Alene, ID 83814-2668 | 2018-07-11 |
| 1841690989 | Jessica Brown | Nurse Practitioner | 980 W Ironwood Dr Ste 201, Coeur D Alene, ID 83814-2668 | 2014-08-26 |
| 1275977399 | Jennifer Anne Farwell | Obstetrics & Gynecology | 980 W Ironwood Dr Ste 201, Coeur D Alene, ID 83814-2668 | 2013-04-19 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740249275 | Daryl K Maccarter | Specialist | 950 W Ironwood Dr, Coeur D Alene, ID 83814-2644 | 2006-03-22 |
| 1326034430 | Jonathan S King | Specialist | 850 W Ironwood Dr Ste 202, Coeur D Alene, ID 83814-4903 | 2005-09-23 |
| 1467448860 | Lloyd E. Witham | Specialist | 1107 W Ironwood Dr, Coeur D Alene, ID 83814-2604 | 2005-09-21 |
| 1174000566 | Timothy Wayne Cork | Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-27 |
| 1952772196 | Gayle Dohrman | Specialist | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2628 | 2015-10-14 |
| 1740539725 | Gregory R. Keese, M.d., P.C. | Specialist | 1107 W Ironwood Dr, Coeur D Alene, ID 83814-2604 | 2012-09-05 |
| 1619278082 | Kala Marie Moore | Specialist | 852 W Kathleen Ave, Coeur D Alene, ID 83815-9405 | 2010-11-16 |
| 1700107612 | Jill Peterson | Specialist | 6125 N Sunshine St, Coeur D Alene, ID 83815 | 2010-06-15 |
| 1003050527 | Peter C Jones Md Pa | Specialist | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2009-04-28 |
| 1013184837 | Maryanne Kleven | Specialist | 500 W Aqua Ave, Coeur D Alene, ID 83815-7764 | 2008-05-12 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on COEUR OBSTETRICS AND GYNECOLOGY, PLLC.
| 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.