MOSCOW FAMILY MEDICINE CLINIC – NPI #1538634522
Family Medicine

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.

MOSCOW FAMILY MEDICINE CLINIC is a provider located in MOSCOW, ID. NPPES has assigned the NPI number 1538634522 to MOSCOW FAMILY MEDICINE CLINIC on October 05, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MOSCOW FAMILY MEDICINE CLINIC” is a dba name, the actual legal business name for this organization is GRITMAN MEDICAL CENTER, INC.. According to the NPI Registry, there are 3 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 8 years ago on Oct 15, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MOSCOW FAMILY MEDICINE CLINIC below.

NPI Profile for
GRITMAN MEDICAL CENTER, INC.

NPI Number
1538634522
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRITMAN MEDICAL CENTER, INC.
Doing Business As (dba): MOSCOW FAMILY MEDICINE CLINIC
Primary location
623 S MAIN ST STE 1
MOSCOW, ID 83843-3042
Phone: (208) 882-2011 Fax: (208) 883-1853
3 Other location(s):
2500 W A St Ste 101
Moscow, ID 83843-6000
Phone: (208) 882-0540
Fax: (208) 882-1853
2500 W A St Ste 101
Moscow, ID 83843-6000
Phone: (208) 882-2011
Fax: (208) 883-1853
831 Ash St
Moscow, ID 83843
Phone: (208) 885-6693
Fax: (208) 883-1853
Mailing address
700 S MAIN ST
MOSCOW, ID 83843-3046
Phone: (208) 882-4511 Fax: (208) 883-6580
Organization Subpart
Yes - MOSCOW FAMILY MEDICINE CLINIC is subpart of another organization.
Authorized Official
DANIELLE LYNAS
CFO
Phone: (208) 883-2220
Updated
Identifiers

Identifiers for MOSCOW FAMILY MEDICINE CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERSTATE OF IDAHO LICENSEID39
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.