| Community Care West Side Llc | |
|
765 S Utah Ave Idaho Falls ID 83402-5093 | |
| (208) 525-2600 | |
| (208) 525-2611 |
| Full Name | Community Care West Side Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 765 S Utah Ave, Idaho Falls, Idaho |
| Authorized Official Name and Position | Heather Mcvey (OFFICE MANAGER) |
| Authorized Official Contact | 2085252600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care West Side Llc 765 S Utah Ave Idaho Falls ID 83402-5093 Ph: (208) 525-2600 | Community Care West Side Llc 765 S Utah Ave Idaho Falls ID 83402-5093 Ph: (208) 525-2600 |
| NPI Number | 1295009785 |
|---|---|
| Provider Enumeration Date | 02/29/2012 |
| Last Update Date | 04/05/2017 |
| Medicare PECOS PAC ID | 3678738218 |
|---|---|
| Medicare Enrollment ID | O20120703000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295009785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bryan D Hammar |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1841219987 PECOS PAC ID: 8022007988 Enrollment ID: I20040507000248 |
| Provider Name | Derek R Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306865464 PECOS PAC ID: 2466359799 Enrollment ID: I20041020000902 |
| Provider Name | Trevor R Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639442973 PECOS PAC ID: 1456515840 Enrollment ID: I20120615000028 |
| Provider Name | Rebecca H Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689610842 PECOS PAC ID: 3577568286 Enrollment ID: I20120625000246 |
| Provider Name | Scott Bradley Schaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720410012 PECOS PAC ID: 2961620620 Enrollment ID: I20140821002846 |
| Provider Name | Bryce Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023417037 PECOS PAC ID: 4880919190 Enrollment ID: I20150209001124 |
| Provider Name | Jamie L Gudmunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669853719 PECOS PAC ID: 3971816448 Enrollment ID: I20150714000351 |
| Provider Name | Devn A Frandsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730316043 PECOS PAC ID: 9032344064 Enrollment ID: I20180504001917 |
| Provider Name | Zachary M Buck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871023135 PECOS PAC ID: 3577832302 Enrollment ID: I20190131002816 |
| Provider Name | David Winchester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730655283 PECOS PAC ID: 2466790183 Enrollment ID: I20190205001008 |
| Provider Name | Hailey A Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487125969 PECOS PAC ID: 8921348129 Enrollment ID: I20190326002408 |
| Provider Name | Tina Scoggins |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1689037129 PECOS PAC ID: 3375882988 Enrollment ID: I20191030002281 |
| Provider Name | Rebekah M Lucero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285295634 PECOS PAC ID: 3779915582 Enrollment ID: I20191118000040 |
| Provider Name | Chance D Christensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841784535 PECOS PAC ID: 6305194770 Enrollment ID: I20200612000768 |
| Provider Name | Benjamin Leishman |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1063862977 PECOS PAC ID: 3375839517 Enrollment ID: I20200707002607 |
| Provider Name | Jonathan L Wilford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013203314 PECOS PAC ID: 6800035742 Enrollment ID: I20200929001916 |
| Provider Name | Brandon Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255947255 PECOS PAC ID: 0143633297 Enrollment ID: I20210108001296 |
| Provider Name | Jordan Forbush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821680166 PECOS PAC ID: 5496154684 Enrollment ID: I20210519003174 |
| Provider Name | Annette Mary Tuft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255005104 PECOS PAC ID: 1557759743 Enrollment ID: I20211020001536 |
| Provider Name | Roberta Bostian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972275501 PECOS PAC ID: 4385037514 Enrollment ID: I20220210000411 |
| Provider Name | Tim Robert Schuijt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801550553 PECOS PAC ID: 7113312620 Enrollment ID: I20220321000782 |
| Provider Name | Monique Catron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952066177 PECOS PAC ID: 9537555412 Enrollment ID: I20220331002409 |
| Provider Name | Stephanie Ann Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285392720 PECOS PAC ID: 6002046901 Enrollment ID: I20220414002130 |
| Provider Name | Jenni Lee Borg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356096614 PECOS PAC ID: 8820475031 Enrollment ID: I20220509002011 |
| Provider Name | Alison Noel Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437745528 PECOS PAC ID: 0547647497 Enrollment ID: I20220513001765 |
| Provider Name | Colter Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215670013 PECOS PAC ID: 8224419692 Enrollment ID: I20220715001758 |
| Provider Name | Kimberly Jean Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265155204 PECOS PAC ID: 8426420431 Enrollment ID: I20230220001771 |
| Provider Name | Kelsey Despain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700594967 PECOS PAC ID: 5193198059 Enrollment ID: I20230224001007 |
| Provider Name | Nathan Thompson Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558074955 PECOS PAC ID: 8325405723 Enrollment ID: I20230530002573 |
Shane G Machen, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1995 E 17th St Ste A, Idaho Falls, ID 83404 Phone: 208-522-7666 Fax: 208-524-2821 | |
Physician Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 | |
Family First Medical Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3614 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-552-7700 Fax: 208-552-1783 | |
Imed Hrs Idaho Falls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 801-507-3500 | |
Neville Spinal Balance Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2145 West Broadway Street, Idaho Falls, ID 83402 Phone: 208-522-3130 | |
R.k. Arbon, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 Channing Way, Suite 116, Idaho Falls, ID 83404 Phone: 208-529-0575 Fax: 208-528-0223 | |
Idaho Falls Family & Sports Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404 Phone: 208-524-3416 Fax: 208-524-3138 |