Organization
NORTH IDAHO IMAGING CENTER
Active
Other names
KOOTENAI OUTPATIENT IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS J LEGEL (DELEGATED OFFICIAL)
(208) 666-3200
Entity
Organization
Contact information
Practice address
700 W IRONWOOD DR, SUITE 110, COEUR D ALENE, ID 83814-2656
(208) 666-3200
(208) 666-3217
Mailing address
PO BOX 1335, COEUR D ALENE, ID 83816-1335
(208) 667-9334
(208) 664-2341
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002735600
—
ID
05
—
7058530
—
WA
01
—
86371
BC ID - CDA
ID
01
—
8J422
BC ID - PF
ID
01
—
CR0440
RR MEDICARE
ID
Enumeration date
08/10/2005
Last updated
12/21/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up