| Trace Heavener, DO | |
|
1919 Lincoln Way Ste 415, Coeur D Alene, ID 83814-2527 | |
| (208) 625-4595 | |
| (208) 625-4596 |
| Full Name | Trace Heavener |
|---|---|
| Gender | Male |
| Speciality | Gastroenterology |
| Experience | 10 Years |
| Location | 1919 Lincoln Way Ste 415, 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 |
|---|---|---|---|
| 1841646726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | O-1809 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Bonner General Hospital | Sandpoint, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kootenai Health Inc | 1355792276 | 382 |
| Entity Name | Kootenai Health, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230 |
| 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 |
|---|---|
| Trace Heavener, DO 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-4595 | Trace Heavener, DO 1919 Lincoln Way Ste 415, Coeur D Alene, ID 83814-2527 Ph: (208) 625-4595 |
Diana Johns, Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 2248 W Rosebud Ln, Coeur D Alene, ID 83814 Phone: 907-687-6248 | |
Marc Olav Granrud, Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-6900 Fax: 208-625-6710 | |
Kevin Nathaniel Brown, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-6900 Fax: 208-625-6910 | |
Edward J Macinerney, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 320, Coeur D Alene, ID 83814 Phone: 208-625-5250 Fax: 208-625-5251 | |
Pablo Fernando Michel Sanchez, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 350, Coeur D Alene, ID 83814 Phone: 208-625-5250 Fax: 208-625-5251 | |
Dr. Amanda Rose Liggett, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814 Phone: 208-625-3555 Fax: 208-765-1494 | |
Dr. Robert Scoggins, M.D., PH.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814 Phone: 208-765-1252 Fax: 208-765-1494 |