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KOOTENAI URGENT CARE LLC
NPI 1407172059
Family Medicine in Coeur D Alene, ID

Active since April 07, 2010
566 W PRAIRIE AVE, COEUR D ALENE, ID 83815(208) 772-9110(208) 772-0590 Get Directions Write a Review

NPPES record last updated: March 22, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kootenai Urgent Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOOTENAI URGENT CARE LLC (NPI 1407172059) is a healthcare organization registered as a family medicine in Coeur D Alene, Idaho and active in the NPI registry since April 2010. The organization lists Eric Koelsch, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1407172059
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKOOTENAI URGENT CARE LLC
Location Address566 W PRAIRIE AVECoeur D Alene, ID 83815-7766
Mailing Address700 W Ironwood Dr, Suite 272eCoeur D Alene, ID 83814-2656 · (208) 676-0102 · Fax (208) 676-0147
Phone(208) 772-9110
Fax(208) 772-0590
Organization SubpartNo
Authorized OfficialEric KoelschExecutive Director · (208) 676-0145
Enumeration DateApril 7, 2010
Last NPPES UpdateMarch 22, 2012
✔ NPI 1407172059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
566 W PRAIRIE AVE, Coeur D Alene, ID 83815
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Other Identifiers 3

Medicare NSC6396800003ID
OtherDQ3168ID · Railroad Medicare
Other1369049ID · Medicare Part B Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kootenai Urgent Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

23

Medicare enrollment records show 23 clinicians reassign Medicare billing to Kootenai Urgent Care LLC, which bills Medicare for the services they deliver. Of these, 14 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Nurse Practitioner15
Family Practice6
Emergency Medicine2

Nearest to this location (20)

See all 23
Justin Henderson, NP
Nurse Practitioner
NPI 1770112138
151 W PRAIRIE AVE
Hayden, ID 83835
(208) 719-4880
✔ PECOS✔ Accepts Medicare0.3 mi
Kristy Graham, FNP-BC
Nurse Practitioner
NPI 1134749898
1270 N NORTHWOOD CENTER CT
Coeur D Alene, ID 83814
(208) 966-4376
✔ PECOS✔ Accepts Medicare3.2 mi
Yendi Labelle, APRN
Nurse Practitioner
NPI 1043838634
2201 N IRONWOOD PL STE 200
Coeur D Alene, ID 83814
(208) 269-5311
✔ PECOS3.3 mi
Ryan Hale
Nurse Practitioner
NPI 1861199721
2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814
(208) 625-4000
✔ PECOS✔ Accepts Medicare3.3 mi
Christian Menard, M.D., PH.D.
Emergency Medicine
NPI 1306082037
2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814
(208) 625-5700
✔ PECOS3.3 mi
Rebecca Dillman
Nurse Practitioner
NPI 1659128551
1090 W PARK PL
Coeur D Alene, ID 83814
(208) 215-2005
✔ PECOS✔ Accepts Medicare3.4 mi
Sandra Kibler, CFNP
Nurse Practitioner
NPI 1912470212
700 W. IRONWOOD DRIVE SUITE 155
Coeur D'alene, ID 83814
(208) 667-0585
✔ PECOS✔ Accepts Medicare3.5 mi
Robin Beard, ARNP
Nurse Practitioner
NPI 1033751078
700 W IRONWOOD DR STE 120
Coeur D Alene, ID 83814
(208) 625-3640
✔ PECOS✔ Accepts Medicare3.5 mi
Meredith Mcalpine, MD
Family Practice
NPI 1245694561
700 W IRONWOOD DR STE 120
Coeur D Alene, ID 83814
(208) 625-3640
✔ PECOS✔ Accepts Medicare3.5 mi
Vadim Pustynovich, FNP-C
Nurse Practitioner
NPI 1518507086
700 W IRONWOOD DR STE 120
Coeur D Alene, ID 83814
(208) 625-3640
✔ PECOS✔ Accepts Medicare3.5 mi
Hollie Mills
Family Practice
NPI 1871905562
1919 LINCOLN WAY STE 315
Coeur D Alene, ID 83814
(208) 625-6001
✔ PECOS✔ Accepts Medicare3.5 mi
John Mitchell, M.D.
Family Practice
NPI 1770015471
1919 LINCOLN WAY STE 315
Coeur D Alene, ID 83814
(208) 625-6000
✔ PECOS✔ Accepts Medicare3.5 mi
Holly Bassler, D.O.
Family Practice
NPI 1437103009
1300 E MULLAN AVE STE 1300
Post Falls, ID 83854
(208) 625-5630
✔ PECOS✔ Accepts Medicare6.6 mi
Tiffany Schaber, ARNP
Nurse Practitioner
NPI 1780465799
1300 E MULLAN AVE STE 1600
Post Falls, ID 83854
(208) 625-4965
✔ PECOS✔ Accepts Medicare6.6 mi
Christy Sutton, FNP
Nurse Practitioner
NPI 1457622078
1334 N WHITMAN LN SUITE 200
Liberty Lake, WA 99019
(509) 688-6700
✔ PECOS✔ Accepts Medicare16 mi
Mindyn Helms, FNP-C
Nurse Practitioner
NPI 1982434841
15605 E SPRAGUE AVE
Spokane Valley, WA 99037
(509) 598-7820
✔ PECOS✔ Accepts Medicare20 mi
Nicole Bruey-Pernell, APRN
Nurse Practitioner
NPI 1386253714
4815 N ASSEMBLY ST
Spokane, WA 99205
(509) 434-7000
✔ PECOS✔ Accepts Medicare32 mi
Bradley Bowman, M.D.
Family Practice
NPI 1326070665
3355 FOOTHILL RD
Moscow, ID 83843
(509) 332-2517
✔ PECOS✔ Accepts Medicare66 mi
Kerri Ruddell, NP
Nurse Practitioner
NPI 1174183578
502 E AMENDE DR
Odessa, WA 99159
(509) 982-2611
✔ PECOS✔ Accepts Medicare93 mi
Chantell Williams, FNP-BC
Nurse Practitioner
NPI 1720432230
402 LAKE CASCADE PKWY
Cascade, ID 83611
(208) 382-4285
✔ PECOS✔ Accepts Medicare226 mi
See all 23 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kootenai Urgent Care LLC's NPI number?

The NPI number for Kootenai Urgent Care LLC is 1407172059. It was assigned to this organization in the NPPES registry on April 7, 2010.

Where is Kootenai Urgent Care LLC located?

Kootenai Urgent Care LLC is located at 566 W Prairie Ave, Coeur D Alene, ID 83815. The listed phone number is (208) 772-9110.

What is Kootenai Urgent Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kootenai Urgent Care LLC enrolled in Medicare?

Yes. Kootenai Urgent Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kootenai Urgent Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 23 clinicians in 3 Medicare specialties reassign their Medicare billing to Kootenai Urgent Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (15), Family Practice (6) and Emergency Medicine (2). Of these, 14 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kootenai Urgent Care LLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Kootenai Urgent Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kootenai Urgent Care LLC was last updated on March 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.