Kendra Mae Black-smith, MD | |
2003 Kootenai Health Way, Coeur D Alene, ID 83814 | |
(208) 625-5185 | |
(208) 625-6892 |
Full Name | Kendra Mae Black-smith |
---|---|
Gender | Female |
Speciality | Pediatrics - Neonatal-perinatal Medicine |
Location | 2003 Kootenai Health Way, Coeur D Alene, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790866044 | NPI | - | NPPES |
272030 | Other | INTERNAL ID-MOTOR VEHICLE ID | |
8269235 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | MD00039197 (Washington) | Secondary |
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | M14495 (Idaho) | Primary |
Entity Name | The Association Of University Physicians |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023041159 PECOS PAC ID: 0446162697 Enrollment ID: O20031105000244 |
Entity Name | The Association Of Chrmc And University Physicians |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255449963 PECOS PAC ID: 9133032964 Enrollment ID: O20031107000585 |
Mailing Address | Practice Location Address |
---|---|
Kendra Mae Black-smith, MD 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-5059 | Kendra Mae Black-smith, MD 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Ph: (208) 625-5185 |
Dr. Thomas R Rau, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 | |
Terence Earl Neff, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 | |
Dr. Brook Yuknis Lang, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5185 Fax: 208-625-5892 | |
Dr. Mary Jo Shaw, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 | |
Dr. Beth Ann Martin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1090 W Park Pl, Coeur D Alene, ID 83814 Phone: 208-215-2005 | |
Dr. Cheri Kathleen Savage, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 | |
Christy L Riley, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 980 W Ironwood Dr, Suite 302, Coeur D Alene, ID 83814 Phone: 208-292-5437 Fax: 208-292-5437 |