| Caldwell Immediate Care | |
|
2701 Carriage Way Twin Falls ID 83301-5257 | |
| (208) 320-0258 | |
| Not Available |
| Full Name | Caldwell Immediate Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 2701 Carriage Way, Twin Falls, Idaho |
| Authorized Official Name and Position | Jonathan Bruce Pittard (OWNER/PROVIDER) |
| Authorized Official Contact | 2083200258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Immediate Care 2701 Carriage Way Twin Falls ID 83301-5257 Ph: (208) 320-0258 | Caldwell Immediate Care 2701 Carriage Way Twin Falls ID 83301-5257 Ph: (208) 320-0258 |
| NPI Number | 1154709863 |
|---|---|
| Provider Enumeration Date | 05/13/2015 |
| Last Update Date | 05/26/2015 |
| Medicare PECOS PAC ID | 3678881893 |
|---|---|
| Medicare Enrollment ID | O20151007001816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154709863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | SPHY-345 (Idaho) | Primary |
| Provider Name | Jenifer A Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679892335 PECOS PAC ID: 5395878862 Enrollment ID: I20100804000485 |
| Provider Name | Travis L Page |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396760385 PECOS PAC ID: 5193727956 Enrollment ID: I20151106000877 |
| Provider Name | Billie Sue Mayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396245742 PECOS PAC ID: 4981967189 Enrollment ID: I20180423001674 |
| Provider Name | Mindy Lee Degeus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316589278 PECOS PAC ID: 1557793569 Enrollment ID: I20191113001238 |
| Provider Name | Garrett Wayne Sweet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558040824 PECOS PAC ID: 4981051695 Enrollment ID: I20231116002600 |
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