{"npi":"1407335367","type":"NPI-2","status":"active","name":{"display":"Beacon Cancer Care PLLC","other":[],"organization_name":"BEACON CANCER CARE PLLC","authorised_official":"David Bartels"},"specialty":{"primary_taxonomy":"261QM1300X","primary_taxonomy_description":"Multi-Specialty Clinic/Center","slug":"multi-specialty-clinic-center","schema_org_specialty":null,"all":[{"code":"207RH0000X","description":"Hematology (Internal Medicine) Physician","primary":false,"state":null,"license":null},{"code":"207RH0003X","description":"Hematology & Oncology","primary":false,"state":null,"license":null},{"code":"207RR0500X","description":"Rheumatology Physician","primary":false,"state":null,"license":null},{"code":"207RX0202X","description":"Medical Oncology Physician","primary":false,"state":null,"license":null},{"code":"2085R0001X","description":"Radiation Oncology Physician","primary":false,"state":null,"license":null},{"code":"261QX0200X","description":"Oncology Clinic/Center","primary":false,"state":null,"license":null},{"code":"261QX0203X","description":"Radiation Oncology Clinic/Center","primary":false,"state":null,"license":null},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":null,"license":null},{"code":"363L00000X","description":"Nurse Practitioner","primary":false,"state":null,"license":null},{"code":"261QM1300X","description":"Multi-Specialty Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"3815 N SCHREIBER WAY STE 101","city":"COEUR D ALENE","state":"ID","postal_code":"838158362","country_code":"US","phone":"2087552804","fax":"2087650277"},{"purpose":"MAILING","street_1":"3815 N SCHREIBER WAY STE 101","city":"COEUR D ALENE","state":"ID","postal_code":"838158362","country_code":"US","phone":"2087552804","fax":"2087650277"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1407335367","state":"ID","issuer":null},{"type_code":"05","label":"Medicaid","value":"2107483","state":"WA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20181004002759","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"ID","pac_id":"6901158773"}]},"enumeration_date":"2018-08-11","last_updated":"2023-08-25","_meta":{"source":"NPPES","snapshot_date":"2023-08-25","doc_url":"https://findmynpi.com/api"}}