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MOSCOW FAMILY MEDICINE CLINIC
NPI 1538634522
Family Medicine in Moscow, ID

Active since October 05, 2018CLIA 13D0938809 · Accreditation
623 S MAIN ST STE 1, MOSCOW, ID 83843(208) 882-2011(208) 883-1853 Get Directions Write a Review

NPPES record last updated: October 15, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 15, 2018, Oct 5, 2018 (2 updates tracked since 2018).

About Moscow Family Medicine Clinic NPPES

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

MOSCOW FAMILY MEDICINE CLINIC (NPI 1538634522) is a healthcare organization registered as a family medicine in Moscow, Idaho and active in the NPI registry since October 2018. The organization holds an CLIA Accreditation certificate valid through November 24, 2027, maintains 2 additional practice locations, and lists Danielle Lynas, Cfo, as its authorized official.

NPPES Registry Identity

NPI1538634522
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGRITMAN MEDICAL CENTER, INC.
Location Address623 S MAIN ST STE 1Moscow, ID 83843-3042
Mailing Address700 S Main StMoscow, ID 83843-3046 · (208) 882-4511 · Fax (208) 883-6580
Phone(208) 882-2011
Fax(208) 883-1853
Organization SubpartYes
Authorized OfficialDanielle LynasCfo · (208) 883-2220
Enumeration DateOctober 5, 2018
Last NPPES UpdateOctober 15, 20182 updates tracked since enumeration
✔ NPI 1538634522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

623 S MAIN ST STE 1, Moscow, ID 83843
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Other Names 1

Doing Business AsMoscow Family Medicine Clinic

Secondary Practice Locations 2

Location 12500 W A St Ste 101Moscow, ID 83843-6000 · Phone (208) 882-0540 · Fax (208) 882-1853
Location 2831 Ash StMoscow, ID 83843 · Phone (208) 885-6693 · Fax (208) 883-1853

Other Identifiers 1

Other39ID · State Of Idaho License

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 13D0938809

Gritman Medical Center Inc Dba Moscow Family Medicine Quickcare Laboratory · Moscow, ID
Active · expires Nov 24, 2027
CLIA Number13D0938809
Laboratory TypePhysician Office
Certificate Effective DateNovember 25, 2025
Certificate Expiration DateNovember 24, 2027
Laboratory DirectorAusten G. Beck
Laboratory Phone(208) 882-0540
Laboratory LocationGritman Medical Center Inc Dba Moscow Family Medicine Quickcare Laboratory2500 West A St #101, Moscow, ID 83843
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAREN LOOMIS COX
Counselor (Mental Health)
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
WENDY MONIQUE GOODRICH PA C
Physician Assistant
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
KYRSTEN E STOOPS MD
Family Medicine
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
SUMMER LYNN DAY MD
Pediatrics
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
AMY ELIZABETH DUDLEY
Family Medicine
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
DR. BRYN ELISE PARKER M.D.
Family Medicine
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
ROBIN ASHLEY SAUTTER MD
Family Medicine
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011
JESSICA E BONNETT DO
Family Medicine
623 S MAIN ST STE 1
MOSCOW, ID 83843
Latah County (208) 882-2011

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 Gritman Medical Center, Inc.'s NPI number?

The NPI number for Gritman Medical Center, Inc. is 1538634522. It was assigned to this organization in the NPPES registry on October 5, 2018. The provider is doing business as Moscow Family Medicine Clinic.

Where is Gritman Medical Center, Inc. located?

Gritman Medical Center, Inc. is located at 623 S Main St Ste 1, Moscow, ID 83843. The listed phone number is (208) 882-2011.

What is Gritman Medical Center, Inc.'s specialty?

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

Does Gritman Medical Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 13D0938809) is associated with this NPI, valid through November 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gritman Medical Center, Inc. was last updated on October 15, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.