NPI age
5 years
Enumerated 2021-03-27
● Active
Type 1 · Individual
Tanner Souza, DO
Souza is 1 of 93 family medicine providers in Coeur D Alene and 1 of 1691 in Idaho.
Primary specialty
Family Medicine
Plus 1 subspecialty
Licensed in
ID, NV
2 states
Status
Active
No deactivations on record
Last NPPES update
2024-08-23
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1691 active family medicine providers in Idaho.
NPI age
5 years
↓ 12 yr below median (17 yr)
State licenses
2 states
Top 85% — 14% of peers are multi-state
Subspecialties
1
In the 31% of peers with subspecialties
NPI lifetime · 2021 → 2026
2021-03Enumerated in NPPES
2021
2026
Where they practice
Practice location
1130 W Prairie Ave
Coeur D Alene, ID 838158780
Mailing address
Po Box 1517
Pendleton, OR 978010410
Additional practice locations
1 secondary location on file with NPPES.
Location 2
6655 S Cimarron Rd Ste 100
Las Vegas, NV 891132181
Specialties
-
Family Medicine PrimaryFamily 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...
-
General PracticeA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice context
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.