| Primary Health Medical Group | |
|
10482 W Carlton Bay Dr Garden City ID 83714-5143 | |
| (208) 955-6500 | |
| (208) 955-6503 |
| Full Name | Primary Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 10482 W Carlton Bay Dr, Garden City, Idaho |
| Authorized Official Name and Position | David L Peterman (PRESIDENT) |
| Authorized Official Contact | 2089556500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Health Medical Group Po Box 191050 Boise ID 83719-1050 Ph: (208) 955-6500 | Primary Health Medical Group 10482 W Carlton Bay Dr Garden City ID 83714-5143 Ph: (208) 955-6500 |
| NPI Number | 1568413920 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 01/07/2011 |
| Medicare PECOS PAC ID | 3971544685 |
|---|---|
| Medicare Enrollment ID | O20050512000561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568413920 | NPI | - | NPPES |
| 807138900 | Medicaid | ID | |
| 807139000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sam G Battaglia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255383055 PECOS PAC ID: 7416851506 Enrollment ID: I20031120000796 |
| Provider Name | Lloyd D Stolworthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831264878 PECOS PAC ID: 6204732233 Enrollment ID: I20031210000807 |
| Provider Name | Patrick D Stowell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720022239 PECOS PAC ID: 8729069604 Enrollment ID: I20040526001219 |
| Provider Name | Martin R Tubach |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1982656591 PECOS PAC ID: 6507848421 Enrollment ID: I20040603001480 |
| Provider Name | Matthew M Bender |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1881633162 PECOS PAC ID: 5698755304 Enrollment ID: I20040722001326 |
| Provider Name | Scott D Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144237975 PECOS PAC ID: 2961475454 Enrollment ID: I20040813000418 |
| Provider Name | Marisa A Battaglia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093074577 PECOS PAC ID: 9830155159 Enrollment ID: I20041208000118 |
| Provider Name | Donald David Hartman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588669410 PECOS PAC ID: 6406814755 Enrollment ID: I20050103000786 |
| Provider Name | Bruce L Belzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083666382 PECOS PAC ID: 9739137928 Enrollment ID: I20050104000961 |
| Provider Name | Stephen C Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154362804 PECOS PAC ID: 6204882764 Enrollment ID: I20050328000783 |
| Provider Name | Gerard R W Klomp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952351710 PECOS PAC ID: 8325089840 Enrollment ID: I20050516000324 |
| Provider Name | Robert A Lyons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699712034 PECOS PAC ID: 6204877731 Enrollment ID: I20050516000343 |
| Provider Name | Daniel C Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699719807 PECOS PAC ID: 4082655980 Enrollment ID: I20050520000767 |
| Provider Name | Mark J Michaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780621128 PECOS PAC ID: 6406890912 Enrollment ID: I20050615000813 |
| Provider Name | Angela L House |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700828241 PECOS PAC ID: 6002845344 Enrollment ID: I20050808000563 |
| Provider Name | James M Yerger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265477962 PECOS PAC ID: 7810928223 Enrollment ID: I20050825000619 |
| Provider Name | Kimberly D Ferguison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356306740 PECOS PAC ID: 6901885755 Enrollment ID: I20060207000758 |
| Provider Name | Katie Weller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275584534 PECOS PAC ID: 4880607977 Enrollment ID: I20060712000197 |
| Provider Name | Michael A Kaylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104878610 PECOS PAC ID: 1355345216 Enrollment ID: I20060907000080 |
| Provider Name | Scott A Culpepper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952321606 PECOS PAC ID: 5294776399 Enrollment ID: I20061102000121 |
| Provider Name | Angela D Pellant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780626358 PECOS PAC ID: 9335233816 Enrollment ID: I20070913000874 |
| Provider Name | Susan C Kim |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1265478531 PECOS PAC ID: 4880789981 Enrollment ID: I20071004000485 |
| Provider Name | Robert Duff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801089255 PECOS PAC ID: 5799873352 Enrollment ID: I20071114000532 |
| Provider Name | Janine A Stone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306948062 PECOS PAC ID: 8820055171 Enrollment ID: I20080923000611 |
| Provider Name | Lois R Niska |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922004878 PECOS PAC ID: 1052366671 Enrollment ID: I20090430000596 |
| Provider Name | Toby A Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891987467 PECOS PAC ID: 7012001142 Enrollment ID: I20090611000266 |
| Provider Name | Shelley R Ringo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316143886 PECOS PAC ID: 1355422999 Enrollment ID: I20090808000140 |
| Provider Name | Ryan A Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386664654 PECOS PAC ID: 5991859142 Enrollment ID: I20090821000517 |
| Provider Name | Kristyn A Schelhaas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366453524 PECOS PAC ID: 1951497163 Enrollment ID: I20090821000671 |
| Provider Name | John P Mullins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558307280 PECOS PAC ID: 0749360451 Enrollment ID: I20090826000707 |
| Provider Name | Timothy Hodges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225027253 PECOS PAC ID: 4587642848 Enrollment ID: I20100304000767 |
| Provider Name | Rick N Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558351551 PECOS PAC ID: 1052417219 Enrollment ID: I20100315000923 |
| Provider Name | Lee W Parsons |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831169598 PECOS PAC ID: 8224044722 Enrollment ID: I20100414000851 |
| Provider Name | Ann M Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013094820 PECOS PAC ID: 0446300263 Enrollment ID: I20100622000683 |
| Provider Name | Mark Alexander Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376707034 PECOS PAC ID: 5092830570 Enrollment ID: I20100921001004 |
| Provider Name | Derek B Hamblin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790713204 PECOS PAC ID: 1658371620 Enrollment ID: I20100924000666 |
| Provider Name | April L Dillion-bialobrzeski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033329842 PECOS PAC ID: 9133272719 Enrollment ID: I20110919000361 |
| Provider Name | Travis W Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235189622 PECOS PAC ID: 6406886928 Enrollment ID: I20120220000255 |
| Provider Name | Matthew J Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669633798 PECOS PAC ID: 9234399288 Enrollment ID: I20120328000657 |
| Provider Name | Sonya L Crum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720341456 PECOS PAC ID: 5496911075 Enrollment ID: I20120726000012 |
| Provider Name | David R Hulbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730313586 PECOS PAC ID: 5496910309 Enrollment ID: I20120906000657 |
| Provider Name | Cyrus H Vania |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740593862 PECOS PAC ID: 1153565031 Enrollment ID: I20130913000810 |
| Provider Name | Amber M Vania |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922311042 PECOS PAC ID: 9133354814 Enrollment ID: I20131105001359 |
| Provider Name | Nathan J Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487967089 PECOS PAC ID: 5698901049 Enrollment ID: I20131113001826 |
| Provider Name | Tyler Hudon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295097012 PECOS PAC ID: 2567692486 Enrollment ID: I20140618001344 |
| Provider Name | Derek Daniel Hayton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821384579 PECOS PAC ID: 7315184207 Enrollment ID: I20140808000886 |
| Provider Name | Frank D Macdonald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255602918 PECOS PAC ID: 5294959540 Enrollment ID: I20140811001925 |
| Provider Name | Abby M Luensmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538505276 PECOS PAC ID: 0244452092 Enrollment ID: I20141110002570 |
| Provider Name | Ryan J Harris |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952628745 PECOS PAC ID: 4981917747 Enrollment ID: I20150722005204 |
| Provider Name | Bartholomew M Ripepi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073873188 PECOS PAC ID: 7012233315 Enrollment ID: I20150805007207 |
| Provider Name | Kelly Wilkinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245522036 PECOS PAC ID: 3274757075 Enrollment ID: I20150901002007 |
| Provider Name | Craig Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184021263 PECOS PAC ID: 8729395496 Enrollment ID: I20150911001929 |
| Provider Name | Christina J Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164898201 PECOS PAC ID: 1254648868 Enrollment ID: I20150915001415 |
| Provider Name | George Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972540870 PECOS PAC ID: 6800808544 Enrollment ID: I20151217000555 |
| Provider Name | Donna M Horan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053395772 PECOS PAC ID: 8628075751 Enrollment ID: I20160509001412 |
| Provider Name | Yvette Sweet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497759088 PECOS PAC ID: 1658396841 Enrollment ID: I20160926000594 |
| Provider Name | Charalee Basaldua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609036086 PECOS PAC ID: 6305019860 Enrollment ID: I20170210002153 |
| Provider Name | Paul Phail |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336554674 PECOS PAC ID: 1850690454 Enrollment ID: I20170719002031 |
| Provider Name | Rory Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225567431 PECOS PAC ID: 8820362908 Enrollment ID: I20170928001685 |
| Provider Name | Steven Barnum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104026178 PECOS PAC ID: 2769757103 Enrollment ID: I20171010003742 |
| Provider Name | Jacob Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265812796 PECOS PAC ID: 3577879774 Enrollment ID: I20171026003668 |
| Provider Name | Delores F Maybach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689191140 PECOS PAC ID: 2163797085 Enrollment ID: I20171227002648 |
| Provider Name | Kirsten F Lamb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932602687 PECOS PAC ID: 6305109620 Enrollment ID: I20180418001844 |
| Provider Name | Trent B Giles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457738841 PECOS PAC ID: 5698057495 Enrollment ID: I20180813000998 |
| Provider Name | Mary E. Nagle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518253848 PECOS PAC ID: 3072747484 Enrollment ID: I20180924001350 |
| Provider Name | Peter Joseph Giordano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326400037 PECOS PAC ID: 9739487596 Enrollment ID: I20181004000563 |
| Provider Name | Kelly Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104303072 PECOS PAC ID: 4082966767 Enrollment ID: I20181008001377 |
| Provider Name | Ginger L Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659872000 PECOS PAC ID: 3779828165 Enrollment ID: I20181212002211 |
| Provider Name | Jedd D Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902380371 PECOS PAC ID: 1850636770 Enrollment ID: I20181221000831 |
| Provider Name | Nicole Augusta Stivers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558370254 PECOS PAC ID: 8527083500 Enrollment ID: I20190325000600 |
| Provider Name | Ginger A. Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568490340 PECOS PAC ID: 0244231140 Enrollment ID: I20190627003535 |
| Provider Name | Brian C Cey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659939031 PECOS PAC ID: 0042547226 Enrollment ID: I20190809003054 |
| Provider Name | Ryan Anthony Baugher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033595905 PECOS PAC ID: 3072841030 Enrollment ID: I20190828004321 |
| Provider Name | Matt Mors |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871904698 PECOS PAC ID: 9638399520 Enrollment ID: I20190903003307 |
| Provider Name | Thiago D Alberto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023650512 PECOS PAC ID: 9133552474 Enrollment ID: I20191127001404 |
| Provider Name | Hailey M Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275175291 PECOS PAC ID: 6204269343 Enrollment ID: I20191204001458 |
| Provider Name | Sandra Messmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891273652 PECOS PAC ID: 7810241643 Enrollment ID: I20191204001538 |
| Provider Name | Andrea Nicole Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992341150 PECOS PAC ID: 0042645970 Enrollment ID: I20200122002352 |
| Provider Name | April Cass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710450333 PECOS PAC ID: 7214365204 Enrollment ID: I20200325003568 |
| Provider Name | Elizabeth B Whitman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649801069 PECOS PAC ID: 9436588340 Enrollment ID: I20200327002435 |
| Provider Name | Brian P Hauser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982674438 PECOS PAC ID: 7113994039 Enrollment ID: I20200727002344 |
| Provider Name | Gabrielle I Trenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932727823 PECOS PAC ID: 1850716408 Enrollment ID: I20200730000991 |
| Provider Name | Matthew Robert Sara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275979346 PECOS PAC ID: 3870727068 Enrollment ID: I20200814002689 |
| Provider Name | Blair C Swearingen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306458534 PECOS PAC ID: 5597182881 Enrollment ID: I20200901002279 |
| Provider Name | Zechariah Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104274950 PECOS PAC ID: 0042502684 Enrollment ID: I20200918002068 |
| Provider Name | Jessica L Ahlers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528661154 PECOS PAC ID: 2860804101 Enrollment ID: I20201210001720 |
| Provider Name | Crystalyn Lou Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649813577 PECOS PAC ID: 7012320229 Enrollment ID: I20210107001865 |
| Provider Name | Brandon Kruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891308094 PECOS PAC ID: 2264847375 Enrollment ID: I20210224000574 |
| Provider Name | Joshua Allen Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568789980 PECOS PAC ID: 8527360890 Enrollment ID: I20210322002457 |
| Provider Name | Jayson Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982202743 PECOS PAC ID: 1254749211 Enrollment ID: I20210413001354 |
| Provider Name | Samantha Perry Fry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235704537 PECOS PAC ID: 9739580804 Enrollment ID: I20210625002628 |
| Provider Name | Michael Slack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679006076 PECOS PAC ID: 6507296787 Enrollment ID: I20210628001079 |
| Provider Name | Kindra J Galloway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366939423 PECOS PAC ID: 0840693107 Enrollment ID: I20210723001257 |
| Provider Name | Jennifer Lytle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003409913 PECOS PAC ID: 7315340692 Enrollment ID: I20210723002006 |
| Provider Name | Lia Lynne Pele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275105371 PECOS PAC ID: 8123422946 Enrollment ID: I20210802001085 |
| Provider Name | Jessica Michelle Everman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225624711 PECOS PAC ID: 7214331156 Enrollment ID: I20210813002452 |
| Provider Name | Warren Hunter Looney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063671584 PECOS PAC ID: 2466622253 Enrollment ID: I20210924003099 |
| Provider Name | Lenard L Malmin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255908489 PECOS PAC ID: 2365849882 Enrollment ID: I20210927002405 |
| Provider Name | Blair Eby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386307528 PECOS PAC ID: 0244629202 Enrollment ID: I20211111002939 |
| Provider Name | Amy Rose Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225797517 PECOS PAC ID: 5597157305 Enrollment ID: I20220127001561 |
| Provider Name | Christopher Ryan Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225324361 PECOS PAC ID: 1254581234 Enrollment ID: I20220323002210 |
| Provider Name | James Miller Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730487042 PECOS PAC ID: 5597093138 Enrollment ID: I20220505000336 |
| Provider Name | Jacob Majors |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1700154275 PECOS PAC ID: 2365769064 Enrollment ID: I20220708002289 |
| Provider Name | Shauna Rankin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740928837 PECOS PAC ID: 6406236199 Enrollment ID: I20220712002918 |
| Provider Name | Cody Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437714474 PECOS PAC ID: 5193054385 Enrollment ID: I20220713003738 |
| Provider Name | Ammon F Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225693666 PECOS PAC ID: 9032446240 Enrollment ID: I20220808003203 |
| Provider Name | Anna Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427798602 PECOS PAC ID: 7719360692 Enrollment ID: I20220810003759 |
| Provider Name | Devin Alan Milliron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073251989 PECOS PAC ID: 3375914997 Enrollment ID: I20230118002528 |
| Provider Name | Kenna Rae Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124739065 PECOS PAC ID: 8729459292 Enrollment ID: I20230119001706 |
| Provider Name | Ashley Marie Duvall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225759517 PECOS PAC ID: 4688045925 Enrollment ID: I20230124000845 |
| Provider Name | Jason S Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013571439 PECOS PAC ID: 5799012233 Enrollment ID: I20230215003224 |
| Provider Name | Mark Thomas Pyburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871206789 PECOS PAC ID: 4385017524 Enrollment ID: I20230308002434 |
| Provider Name | Sydney Nicole Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053004879 PECOS PAC ID: 5092173161 Enrollment ID: I20230621003246 |
| Provider Name | Tami Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174164263 PECOS PAC ID: 5496184848 Enrollment ID: I20240126001332 |
| Provider Name | Hayley Nicole Schank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295517399 PECOS PAC ID: 0446603369 Enrollment ID: I20240126003635 |
| Provider Name | Mary Meacham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265207534 PECOS PAC ID: 4688011364 Enrollment ID: I20240318003374 |
| Provider Name | Christopher Alexander Cahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902669435 PECOS PAC ID: 8224477666 Enrollment ID: I20240417002730 |
| Provider Name | Lisa Annetta Eichler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174374961 PECOS PAC ID: 9931541075 Enrollment ID: I20240521003529 |
| Provider Name | Samantha J Ruggles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811759426 PECOS PAC ID: 1254773138 Enrollment ID: I20240523000877 |
Healing Touch Osteopathic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10199 W Carlton Bay Dr, Garden City, ID 83714 Phone: 208-488-8408 | |
Sterling Provider Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6965 N Glenwood St, Garden City, ID 83714 Phone: 208-853-3000 Fax: 208-542-9114 | |
Cottonwood Family Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5999 W State St Ste B, Garden City, ID 83703 Phone: 208-995-2875 Fax: 208-995-2874 | |
Afc Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6965 N Glenwood St, Garden City, ID 83714 Phone: 208-853-3000 | |
Primary Health Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5601 W. Chinden Blvd., Garden City, ID 83714 Phone: 208-809-2865 Fax: 208-809-2866 |