Medical Directors Of Idaho Pllc | |
404 N Horton St Nampa ID 83651-6541 | |
(208) 466-9292 | |
Not Available |
Full Name | Medical Directors Of Idaho Pllc |
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Speciality | Internal Medicine |
Location | 404 N Horton St, Nampa, Idaho |
Authorized Official Name and Position | Ryan Williams (RESPONSIBLE PARTY/REPRESENTATIVE) |
Authorized Official Contact | 5025441780 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Medical Directors Of Idaho Pllc Po Box 44527 Boise ID 83711-0527 Ph: (208) 384-9022 | Medical Directors Of Idaho Pllc 404 N Horton St Nampa ID 83651-6541 Ph: (208) 466-9292 |
NPI Number | 1710392410 |
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Provider Enumeration Date | 06/23/2014 |
Last Update Date | 05/16/2023 |
Medicare PECOS PAC ID | 1951628544 |
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Medicare Enrollment ID | O20150319000233 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710392410 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | M-10968 (Idaho) | Primary |
Provider Name | Robert L Petersen |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1043229685 PECOS PAC ID: 2365336492 Enrollment ID: I20040210001003 |
Provider Name | Ryan J Williams |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1114053014 PECOS PAC ID: 7113000282 Enrollment ID: I20100701000171 |
Provider Name | Teresa Morgan |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1225336118 PECOS PAC ID: 8921280686 Enrollment ID: I20110316000999 |
Provider Name | Jenifer L Barry |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1164673968 PECOS PAC ID: 7810181880 Enrollment ID: I20110421000396 |
Provider Name | Derrel V Walker |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1013208495 PECOS PAC ID: 8628293776 Enrollment ID: I20140702002108 |
Provider Name | Jan Rehder King |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083038335 PECOS PAC ID: 4880917087 Enrollment ID: I20141219000077 |
Provider Name | Debra A Phillips |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366741019 PECOS PAC ID: 9830413095 Enrollment ID: I20150116000004 |
Provider Name | Van Ngoc Hoang |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1215293139 PECOS PAC ID: 9133445091 Enrollment ID: I20150820012076 |
Provider Name | Nathan Z Hicks |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1144667817 PECOS PAC ID: 1355668252 Enrollment ID: I20160624001002 |
Provider Name | Adam R Schwind |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1831539220 PECOS PAC ID: 5597081448 Enrollment ID: I20160725001004 |
Provider Name | Tyler G Jue |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033641154 PECOS PAC ID: 9537445374 Enrollment ID: I20170411001127 |
Provider Name | Cameron J Allen |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1730594185 PECOS PAC ID: 4284850215 Enrollment ID: I20170524001125 |
Provider Name | Meaghen Friel |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1407274210 PECOS PAC ID: 7517285422 Enrollment ID: I20170719000021 |
Provider Name | Laura M Eaton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982115309 PECOS PAC ID: 3173882735 Enrollment ID: I20180108000287 |
Provider Name | Jose M Celedon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326520719 PECOS PAC ID: 9436487899 Enrollment ID: I20190822001970 |
Provider Name | Victoria R Byrne |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1124476205 PECOS PAC ID: 0749543239 Enrollment ID: I20191031001109 |
Provider Name | Megan Lenkersdorfer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477197036 PECOS PAC ID: 7315371770 Enrollment ID: I20191231000646 |
Provider Name | Ryan Townsend |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285077701 PECOS PAC ID: 6709102866 Enrollment ID: I20201021001135 |
Provider Name | Tonya J Jenott |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467072660 PECOS PAC ID: 7214344951 Enrollment ID: I20210325001343 |
Hospitalist Medicine Physicians Of Idaho-tcg, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4300 E Flamingo Ave, Nampa, ID 83687 Phone: 208-205-1000 | |
Mercy Physician Group Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1512 12th Ave Rd, Nampa, ID 83686 Phone: 208-463-5000 Fax: 208-463-5578 | |
Greene Mountain Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3719 Wheeler Cir, Nampa, ID 83686 Phone: 208-695-0388 Fax: 208-606-3682 | |
Terry Reilly Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 207 1st St S, Nampa, ID 83651 Phone: 208-466-7869 Fax: 208-466-5359 | |
Northwest Nazarene University Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 S University Blvd, Nampa, ID 83686 Phone: 208-467-8643 | |
C-who Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 824 S Diamond St, Nampa, ID 83686 Phone: 208-606-0396 | |
Healing Arts Day Surgery Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 W Iowa Ave Ste B, Suite B, Nampa, ID 83686 Phone: 208-467-3432 Fax: 208-467-4147 |