NORTH IDAHO DAY SURGERY LLC
Complete NPI Record 1104824739
General Acute Care Hospital in Post Falls, ID
Active since July 08, 2005
Complete NPI Dataset
This page contains the complete raw NPPES record for North Idaho Day Surgery Llc (NPI 1104824739), a general acute care hospital organization in Post Falls, ID. All 55 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1104824739 Field 1/55
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/55
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/55
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: NORTH IDAHO DAY SURGERY LLC Field 4/55
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: Not available Field 5/55
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 6 Field 6/55
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 1593 E POLSTON AVE Field 7/55
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: POST FALLS Field 8/55
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: ID Field 9/55
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 838545326 Field 10/55
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/55
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 2082622300 Field 12/55
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 2082622390 Field 13/55
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 1593 E POLSTON AVE Field 14/55
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: POST FALLS Field 15/55
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: ID Field 16/55
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 838545326 Field 17/55
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/55
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2082622300 Field 19/55
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 2082622390 Field 20/55
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: BELL Field 23/55
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: JASON Field 24/55
- The first name of the authorized official.
- Authorized Official Title or Position: PAYOR ENROLLMENT SPECIALIST Field 25/55
- The title or position of the authorized official.
- Authorized Official Telephone Number: 2086182559 Field 26/55
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 261QM1300X Field 27/55
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 28/55
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 282N00000X Field 29/55
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 65 Field 30/55
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: ID Field 31/55
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 32/55
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 000010145102 Field 33/55
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 34/55
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: ID Field 35/55
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: REGENCE BLUE SHIELD Field 36/55
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 2: 1104824739 Field 37/55
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 05 Field 38/55
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: ID Field 39/55
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 3: 00471 Field 40/55
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 3: 01 Field 41/55
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 3: ID Field 42/55
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 3: BLUE CROSS OF IDAHO Field 43/55
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 4: 0179400 Field 44/55
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 4: 01 Field 45/55
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier Issuer 4: WASHINGTON WORKER COMP Field 46/55
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 5: 1006277 Field 47/55
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 5: 01 Field 48/55
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 5: ID Field 49/55
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 5: STATE INSURANCE FUND Field 50/55
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 6: 823016 Field 51/55
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 6: 01 Field 52/55
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier Issuer 6: FIRST HEALTH Field 53/55
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Organization Subpart: N Field 54/55
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Other Organization Names 1
Additional business and trade names this provider has on file with the NPPES registry.
Northwest Specialty Hospital Doing Business As
Name 1/1Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Secondary Practice Locations 23
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
750 N Syringa St Ste 201
Location 1/23Post Falls, ID 83854-5275 · Phone (208) 262-2379 · Fax (208) 262-2318
750 N Syringa St Ste 205
Location 2/23Post Falls, ID 83854-5275 · Phone (208) 262-0945 · Fax (208) 415-0150
1551 E Mullan Ave Ste 101
Location 3/23Post Falls, ID 83854-9005 · Phone (208) 262-2439 · Fax (208) 508-2259
1624 E Mullan Ave
Location 4/23Post Falls, ID 83854 · Phone (208) 770-2000 · Fax (208) 770-2001
7600 N Mineral Dr Ste 110
Location 5/23Coeur D Alene, ID 83815-7763 · Phone (208) 619-8250 · Fax (208) 981-9201
1551 E Mullan Ave Ste 200A
Location 6/23Post Falls, ID 83854-9005 · Phone (208) 262-2311 · Fax (208) 619-5038
750 N Syringa St Ste 100
Location 7/23Post Falls, ID 83854-5275 · Phone (208) 262-2600 · Fax (208) 262-2700
1551 E Mullan Ave Ste 200C
Location 8/23Post Falls, ID 83854-9005 · Phone (208) 618-2570 · Fax (208) 618-8779
7600 N Mineral Dr Ste 111
Location 9/23Coeur D Alene, ID 83815-9169 · Phone (208) 457-4208 · Fax (208) 457-4197
7173 E Super 1 Loop Ste A
Location 10/23Athol, ID 83801-7109 · Phone (208) 561-9970 · Fax (208) 561-9997
1551 E Mullan Ave Ste 200B
Location 11/23Post Falls, ID 83854-9005 · Phone (208) 262-2213 · Fax (208) 262-2214
1551 E Mullan Ave Ste 102
Location 12/23Post Falls, ID 83854-9005 · Phone (208) 262-2328 · Fax (208) 619-5057
2207 N Molter Rd Ste 101
Location 13/23Liberty Lake, WA 99019-7570 · Phone (509) 324-1222 · Fax (509) 324-1223
622 W College Ave
Location 14/23St Maries, ID 83861-1822 · Phone (208) 568-7800 · Fax (877) 902-7131
1651 E Polston Ave
Location 15/23Post Falls, ID 83854 · Phone (208) 457-4208 · Fax (208) 457-4197
1551 E Mullan Ave Ste 100
Location 16/23Post Falls, ID 83854-9005 · Phone (208) 262-2482 · Fax (208) 262-7460
7173 E Super 1 Loop Ste B
Location 17/23Athol, ID 83801-7109 · Phone (208) 687-4878 · Fax (208) 687-4879
750 N Syringa St Ste 103
Location 18/23Post Falls, ID 83854-5275 · Phone (208) 415-0151 · Fax (208) 777-1591
315 W Dalton Ave Ste A
Location 19/23Coeur D Alene, ID 83815-8600 · Phone (208) 209-2060 · Fax (208) 209-2070
750 N Syringa St Ste 203A
Location 20/23Post Falls, ID 83854-5275 · Phone (208) 262-2717 · Fax (208) 262-2719
1551 E Mullan Ave Ste 200D
Location 21/23Post Falls, ID 83854-9005 · Phone (208) 262-2441 · Fax (208) 262-2390
315 W Dalton Ave Ste B
Location 22/23Coeur D Alene, ID 83815-8600 · Phone (208) 209-2066 · Fax (208) 209-2076
15622 N Highway 41
Location 23/23Rathdrum, ID 83858-8710 · Phone (208) 687-4878 · Fax (208) 687-4879
Other Provider Identifiers 6
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
000010145102 Other
Identifier 1/6State: ID · Issuer: Regence Blue Shield
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
1104824739 Medicaid
Identifier 2/6State: ID
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
00471 Other
Identifier 3/6State: ID · Issuer: Blue Cross Of Idaho
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
0179400 Other
Identifier 4/6Issuer: Washington Worker Comp
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
1006277 Other
Identifier 5/6State: ID · Issuer: State Insurance Fund
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
823016 Other
Identifier 6/6Issuer: First Health
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
No registry entries match your active lookup criteria.
