Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeffrey Wayne Grossman, MD

Individual provider Diagnostic Radiology Physician · NPI 1083751366

Jeffrey Wayne Grossman, MD is a Diagnostic Radiology in Coeur D Alene, Idaho. Qualified in 2002, 24 years ago. Practices with Shannon Clinic, a 547-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
24
Licensed in
ID
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2031 E Mountain Vista Dr
Coeur D Alene, ID 83815-9683
Phone: (208) 570-3342
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence M-10276 (ID)

Record details

NPI number1083751366
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 30, 2007
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Shannon Clinic — 547 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations20 on file with Medicare

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