COEUR OBSTETRICS AND GYNECOLOGY, PLLC
NPI 1730280744
Specialist in Coeur D Alene, ID

NPI Status: Active since September 25, 2006

Contact Information

980 W IRONWOOD DR STE 201
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 765-4888

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Secondary Locations
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Specialist
Accepts Insurance
CLIA Number: 13D0699570
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 08-31-2026

About COEUR OBSTETRICS AND GYNECOLOGY, PLLC

This page provides the complete NPI Profile along with additional information for Coeur Obstetrics And Gynecology, Pllc, a provider established in Coeur D Alene, Idaho operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1730280744 assigned on September 2006. The practitioner's primary taxonomy code is 174400000X with license number M-9485 (ID). The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's former legal business name is D. Anthony & R. Randel Henneberg, Ptr's. The authorized official of this NPI record is Dr. Andrew Anthony Henneberg Md (Owner/md)

NPI: 1730280744
Provider Legal Name: COEUR OBSTETRICS AND GYNECOLOGY, PLLC
Other Organization Name: D. ANTHONY & R. RANDEL HENNEBERG, PTR'S
Other Name Type: Former Legal Business Name (4)
Entity Type: Organization
Location Address: 980 W IRONWOOD DR STE 201 COEUR D ALENE, ID 83814
Location Phone: (208) 765-4888
Mailing Address: 980 W IRONWOOD DR. SUITE 201 COEUR D' ALENE, ID 83814
Mailing Phone: (208) 765-4888
Mailing Fax
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 09-25-2006
Last Update Date: 05-14-2020
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Location Map

Secondary Locations

980 W IRONWOOD DR. SUITE 304
COEUR D' ALENE, ID 83814
(208) 765-4888

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Specialist
Taxonomy Code: 174400000X
Type: Other Service Providers
License No.: M-9485
License State: ID
Taxonomy Description: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Mountain Health CO-OP

Connect Bronze Expanded Standard - PPO
Connect Bronze HDHP - PPO
Connect Catastrophic - PPO
Connect Gold - PPO
Connect Gold Standard - PPO
Connect Silver - PPO
Connect Silver Standard - PPO
High Plains Bronze HDHP - PPO
High Plains Bronze Standard Expanded - PPO
High Plains Gold - PPO
High Plains Gold HDHP - PPO
High Plains Gold Standard - PPO
High Plains Silver - PPO
High Plains Silver Standard - PPO
Plus Bronze Expanded - PPO
Plus Bronze Standard Expanded - PPO
Plus Gold - PPO
Plus Gold Standard - PPO
Plus Silver Standard - PPO
ACCESS BRONZE - PPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: DR. ANDREW ANTHONY HENNEBERG MD
Authorized Official Title: OWNER/MD
Authorized Official Phone: (208) 765-4888

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 13D0699570
Facility Type: Physician Office
Certificate Effective Date: September 01, 2024
Certificate Expiration Date: August 31, 2026
Laboratory Director: ANDREW HENNEBERG
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Coeur Obstetrics And Gynecology, Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	3	0	2	8	0	7	4	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	6	0	4	8	0	7	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 6 + 0 + 4 + 8 + 0 + 7 + 8 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 4									4

The NPI number 1730280744 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.