| Dr Larry L Wellendorf Ii, MD | |
|
2236 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4960 | |
| (208) 625-3670 | |
| (208) 625-3675 |
| Full Name | Dr Larry L Wellendorf Ii |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 33 Years |
| Location | 2236 N Merritt Creek Loop Ste A, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790798593 | NPI | - | NPPES |
| 036091551 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036091551 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | MC-2626 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kootenai Urgent Care Llc | 1052441946 | 19 |
| Entity Name | Kootenai Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821312356 PECOS PAC ID: 1052441946 Enrollment ID: O20100621000358 |
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Entity Name | Kootenai Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Larry L Wellendorf Ii, MD 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-5084 | Dr Larry L Wellendorf Ii, MD 2236 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4960 Ph: (208) 625-3670 |
Samantha Anne Easterly, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1090 W Park Pl, Coeur D Alene, ID 83814 Phone: 208-620-5250 Fax: 844-807-3782 | |
Erica Magers, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 914 W Ironwood Dr Ste 101, Coeur D Alene, ID 83814 Phone: 208-625-3500 Fax: 208-625-3501 | |
Dr. Stephen Paul Smiley, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1130 W Prairie Ave, Coeur D Alene, ID 83815 Phone: 208-209-0288 Fax: 208-209-0289 | |
Katherine J. White, FNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4277 W Fairway Dr, Coeur D Alene, ID 83815 Phone: 602-299-6366 | |
Heidi A Herold, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 W Dalton Ave Ste B, Coeur D Alene, ID 83815 Phone: 208-209-2066 Fax: 208-209-2076 | |
Ryan John Gilles, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1919 Lincoln Way, 315, Coeur D Alene, ID 83814 Phone: 208-625-6000 Fax: 208-625-6001 | |
Dr. Matthew C. Bean, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1919 Lincoln Way Ste 315, Coeur D Alene, ID 83814 Phone: 208-625-6000 Fax: 208-625-6001 |