| Meza Post Acute And Long Term Care, Pllc | |
|
3400 E Fernan Hill Rd Coeur D Alene ID 83814-7588 | |
| (208) 819-2183 | |
| Not Available |
| Full Name | Meza Post Acute And Long Term Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3400 E Fernan Hill Rd, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Michael Meza (OWNER) |
| Authorized Official Contact | 2088192183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meza Post Acute And Long Term Care, Pllc Po Box 3687 Coeur D Alene ID 83816-2529 Ph: (208) 819-2183 | Meza Post Acute And Long Term Care, Pllc 3400 E Fernan Hill Rd Coeur D Alene ID 83814-7588 Ph: (208) 819-2183 |
| NPI Number | 1932725215 |
|---|---|
| Provider Enumeration Date | 06/22/2020 |
| Last Update Date | 12/08/2020 |
| Medicare PECOS PAC ID | 4981028503 |
|---|---|
| Medicare Enrollment ID | O20200715002977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932725215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Barbara A Kammer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306957048 PECOS PAC ID: 9436053980 Enrollment ID: I20031125000725 |
| Provider Name | Michael G Meza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134124506 PECOS PAC ID: 6901940048 Enrollment ID: I20100212000562 |
| Provider Name | William Scott Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255351458 PECOS PAC ID: 7719966811 Enrollment ID: I20120612000136 |
| Provider Name | Julia J Koep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871522037 PECOS PAC ID: 0547164063 Enrollment ID: I20140916000988 |
| Provider Name | Brooke M Skurupey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710396601 PECOS PAC ID: 1254656010 Enrollment ID: I20150219000960 |
| Provider Name | Robert Jordan Lakko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174756340 PECOS PAC ID: 2062648132 Enrollment ID: I20151007000620 |
| Provider Name | Jason R Schwintek |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992864342 PECOS PAC ID: 7810968799 Enrollment ID: I20151022001060 |
| Provider Name | John Bradley Rudolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548503022 PECOS PAC ID: 1759604309 Enrollment ID: I20170116000186 |
| Provider Name | Pushapdeep K Brar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699097279 PECOS PAC ID: 0244400109 Enrollment ID: I20170713001851 |
| Provider Name | Francis Detar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417498247 PECOS PAC ID: 1254601214 Enrollment ID: I20170724003411 |
| Provider Name | Manuela L Orban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063801694 PECOS PAC ID: 8921327461 Enrollment ID: I20171012002934 |
| Provider Name | Samantha Lynn Musser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174017701 PECOS PAC ID: 7416204193 Enrollment ID: I20180726001298 |
| Provider Name | Alexandra Bellem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639533847 PECOS PAC ID: 3870822828 Enrollment ID: I20190917001511 |
| Provider Name | Lembi Che |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508412164 PECOS PAC ID: 6709211485 Enrollment ID: I20200128000678 |
| Provider Name | Brandon L Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124353719 PECOS PAC ID: 9436572740 Enrollment ID: I20201124003092 |
| Provider Name | Janis J Whitehead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316930795 PECOS PAC ID: 4981742491 Enrollment ID: I20210527003233 |
| Provider Name | Lisa Kailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316559073 PECOS PAC ID: 2264847193 Enrollment ID: I20210702000538 |
| Provider Name | Jennifer Stallings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780253989 PECOS PAC ID: 8527460484 Enrollment ID: I20210714002832 |
| Provider Name | Connie Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881228781 PECOS PAC ID: 8123430709 Enrollment ID: I20220531001490 |
| Provider Name | Megan J Beaudin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992492805 PECOS PAC ID: 9830557974 Enrollment ID: I20230621002213 |
| Provider Name | Whitney A Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669178356 PECOS PAC ID: 9335507375 Enrollment ID: I20230622002647 |
| Provider Name | Sara D Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619664646 PECOS PAC ID: 7618336249 Enrollment ID: I20230629003133 |
| Provider Name | Mario Seyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942251293 PECOS PAC ID: 0749248623 Enrollment ID: I20240101000269 |
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