RUSSELL S VANDERWILDE (NPI# 1871562967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871562967 |
| Entity Type | Individual |
| Full Name | RUSSELL S VANDERWILDE |
| Credential | M.D. |
| Practice Address |
601 W 5th Ave Suite 400 Spokane WA 99204-2715 |
| Practice Telephone | 5093442663 |
| Practice Fax Number | 5096249179 |
| Mailing Telephone | 5093442663 |
| Mailing Fax Number | 5096249179 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2008-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MD00030742 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE BS OF IDAHO | 000010002357 | 01 |
| WA | 1083047 | 05 | |
| WA | CRIME VICTIMS | 8919653 | 01 |
| WA | ASURIS NW HEALTH | 3780VA | 01 |
| WA | DEPT OF LABOR & INDUSTRIE | 42091 | 01 |
| WA | RR MEDICARE | 200016187 | 01 |
| WA | GROUP HEALTH NW | 3283 | 01 |
| ID | BLUE CROSS OF IDAHO | K6484 | 01 |
| WA | OWCP | 379109600 | 01 |
| ID | 003297000 | 05 |
| Street Address |
601 W 5TH AVE SUITE 400 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063414878 | Leann G Bach | Physician Assistant | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2715 | 2005-08-11 |
| 1851833669 | Jana Stuckrath | Nurse Practitioner | 601 W 5th Ave, Suite 301, Spokane, WA 99204-2705 | 2016-11-09 |
| 1497112320 | Inspire Physical Therapy Spokane Inc Ps | Physical Therapist | 601 W 5th Ave, Suite 308, Spokane, WA 99204-2705 | 2016-01-22 |
| 1790177822 | Allison Brighton Sayre | Nurse Practitioner | 601 W 5th Ave, Suite 301, Spokane, WA 99204-2705 | 2015-02-26 |
| 1639572985 | Anthony O'neel | Physician Assistant | 601 W 5th Ave, Spokane, WA 99204-2705 | 2014-10-01 |
| 1932513900 | David Allen Baca | Physician Assistant | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2705 | 2014-06-17 |
| 1518393396 | Sally Delger | Nurse Practitioner | 601 W 5th Ave, Suite 301, Spokane, WA 99204-2705 | 2013-09-24 |
| 1699050575 | Brieanne Catherine Gray | Nurse Practitioner | 601 W 5th Ave, Suite #301, Spokane, WA 99204-2714 | 2011-10-11 |
| 1407181019 | Mark Jerome Buescher | Physician Assistant | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2705 | 2009-10-15 |
| 1235327933 | Northwest Orthopaedic Specialists | Orthopaedic Surgery | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2175 | 2007-10-09 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174865216 | Jessica M Kohring | Orthopaedic Surgery | 12410 East Sinto Suite 201, Spokane, WA 99216-1200 | 2013-03-26 |
| 1992083216 | Providence Physician Services Co. | Orthopaedic Surgery | 820 S Mcclellan, Suite 300, Providence Orthopedic Specialties, Spokane, WA 99204 | 2011-08-03 |
| 1275663189 | Warren James Adams | Orthopaedic Surgery | 801 West Fifth Avenue, Suite 304, Spokane, WA 99204-2800 | 2007-03-07 |
| 1477608875 | Christopher Bateman Dewing | Orthopaedic Surgery | 2420 E 29th Ave Ste 100, Spokane, WA 99223-4868 | 2007-01-24 |
| 1639145618 | Andrew T Howlett | Orthopaedic Surgery | 820 S Mcclellan, Ste 300, Spokane, WA 99204-2450 | 2006-02-28 |
| 1457331043 | Glen Olsen Baird | Orthopaedic Surgery | 911 W 5th Ave, Spokane, WA 99204-2901 | 2006-01-19 |
| 1356329114 | Matthew K Wallace | Orthopaedic Surgery | 212 E Central Ave Ste 140, Spokane, WA 99208-6289 | 2006-01-03 |
| 1013917913 | Donald Scott Redman | Orthopaedic Surgery | 624 E Front Ave, Spokane, WA 99202-2139 | 2005-07-21 |
| 1811522501 | Northwest Orthopaedic Specialists, P.s. | Orthopaedic Surgery | 9310 N Division St, Spokane, WA 99218-1227 | 2020-03-03 |
| 1184259871 | Northwest Orthopaedic Specialists Ps | Orthopaedic Surgery | 2710 E 57th Ave, Spokane, WA 99223-6678 | 2020-03-03 |
| 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.