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CLEARWATER MEDICAL CLINIC
NPI 1558452268
Nurse Practitioner - Family in Lewiston, ID

Active since September 27, 2006
1522 17TH ST, LEWISTON, ID 83501(208) 743-8416(208) 743-4642 Get Directions Write a Review

NPPES record last updated: December 16, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clearwater Medical Clinic NPPES

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

CLEARWATER MEDICAL CLINIC (NPI 1558452268) is a healthcare organization registered as a family in Lewiston, Idaho and active in the NPI registry since September 2006. The organization lists Celso R Chavez, Owner Physician, as its authorized official.

NPPES Registry Identity

NPI1558452268
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCLEARWATER MEDICAL CENTER PLLC
Location Address1522 17TH STLewiston, ID 83501-3652
Mailing Address1522 17th StLewiston, ID 83501-3652 · (208) 743-8416 · Fax (208) 743-4642
Phone(208) 743-8416
Fax(208) 743-4642
Organization SubpartNo
Authorized OfficialCelso R ChavezOwner Physician · (208) 743-8416
Enumeration DateSeptember 27, 2006
Last NPPES UpdateDecember 16, 2008
✔ NPI 1558452268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed · NP361A✔ Licensed in ID · NP740A✔ Licensed in ID · NP751A✔ Licensed in ID · NP372A✔ Licensed in ID · NP388A✔ Licensed in ID · NP390A
Also ListedFamily MedicineTaxonomy 207Q00000X · License A87025 (ID)
1522 17TH ST, Lewiston, ID 83501
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Other Names 1

Doing Business AsClearwater Medical Clinic

Other Identifiers 2

Medicare ID-Type Unspecified1372186ID · Group Provider Number
Medicare NSC0466670001ID

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

Other Providers at the Same Location NPPES 13

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

JUDITH ROONEY LCSW
Social Worker (Clinical)
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
CELSO R CHAVEZ MD
Family Medicine
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
CHRISTINE L NORWOOD FNP
Nurse Practitioner (Family)
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
ROBIN L HIGHT FNP
Nurse Practitioner (Family)
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
LACEY STEINWAND
Nurse Practitioner
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
LINDSEY RAE SEIPP APN
Nurse Practitioner
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
CHRISTOPHER J IACOBELLI MD
Family Medicine
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416
GENI L EVANS NP
Nurse Practitioner
1522 17TH ST
LEWISTON, ID 83501
Nez Perce County (208) 743-8416

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 Clearwater Medical Center PLLC's NPI number?

The NPI number for Clearwater Medical Center PLLC is 1558452268. It was assigned to this organization in the NPPES registry on September 27, 2006. The provider is doing business as Clearwater Medical Clinic.

Where is Clearwater Medical Center PLLC located?

Clearwater Medical Center PLLC is located at 1522 17th St, Lewiston, ID 83501. The listed phone number is (208) 743-8416.

What is Clearwater Medical Center PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Clearwater Medical Center PLLC was last updated on December 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.