IVAN J REVERON (NPI# 1750393781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750393781 |
| Entity Type | Individual |
| Full Name | IVAN J REVERON |
| Credential | M.D. |
| Practice Address |
5901 N Lidgerwood St Ste 126 Spokane WA 99208-1122 |
| Mailing Address |
203 N Washington St Ste 300 Spokane WA 99201-0233 |
| Practice Telephone | 5094341990 |
| Practice Fax Number | 5093408986 |
| Mailing Telephone | 5094448888 |
| Mailing Fax Number | 5094447806 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-07-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD60063800 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
5901 N LIDGERWOOD ST STE 126 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-1122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609853993 | Paula A Dygert | Internal Medicine | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208 | 2005-12-28 |
| 1285231589 | Lindsay Brookhart | Nurse Practitioner | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2020-10-08 |
| 1679113260 | Britanie Lynn Speziale | Registered Nurse | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2020-01-10 |
| 1831731454 | Spokane Urgent Care Pharmacy | Pharmacy | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2019-10-15 |
| 1235796251 | Zoey Mckenna Deleon | Registered Nurse | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2019-05-24 |
| 1174180186 | Jeremy Len Burt | Registered Nurse | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2019-05-24 |
| 1053810309 | Brandie Nichole Tilch-bryant | Nurse Practitioner | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2018-02-01 |
| 1225536055 | Amanda Marie Rogers | Registered Nurse | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2018-01-26 |
| 1366967192 | William Matney | Registered Nurse | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2017-08-14 |
| 1932644598 | Jacquelyn Starr | Registered Nurse | 5901 N Lidgerwood St Ste 126, Spokane, WA 99208-1122 | 2017-01-05 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750916953 | Bavihealth | Family Medicine | 1314 S. Grand Blvd, Ste 2 #142, Spokane, WA 99202-2131 | 2020-03-08 |
| 1407487648 | Direct Primary Care | Family Medicine | 212 E Central Ave Ste 360, Spokane, WA 99208-4502 | 2020-01-27 |
| 1710234190 | Mayfield Family Medicine Pllc | Family Medicine | 5901 N Lidgerwood St Ste 127, Spokane, WA 99208-1122 | 2012-08-06 |
| 1427329762 | Charles Robert Wolfe | Family Medicine | 16320 E Lincoln Rd, Spokane, WA 99217-9571 | 2012-01-18 |
| 1952687386 | Providence Phsyician Services | Family Medicine | 1919 S. Grand Blvd., Spokane, WA 99203 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1548552326 | Providence Physician Service Co | Family Medicine | 1919 S Grand Ave, Pmg Providence Family Medicine South Grand, Spokane, WA 99204 | 2011-05-11 |
| 1104125418 | David Raymond O'brien | Family Medicine | 1907 W Summit Pkwy Apt 306, Spokane, WA 99201-3133 | 2011-03-25 |
| 1144540915 | Elizabeth A. Turner, Md | Family Medicine | 316 W. Boone, Suite 669, Spokane, WA 99201-2354 | 2010-06-03 |
| 1083949374 | Opportunity Medical | Family Medicine | 16201 E. Indiana Ave, Ste 2300, Spokane, WA 99216-2839 | 2009-10-05 |
| Find all providers in SPOKANE | ||||
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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.