ANNIS WAKELEE VARGAS (NPI# 1023404811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023404811 |
| Entity Type | Individual |
| Full Name | ANNIS WAKELEE VARGAS |
| Other Name | ANNIE W BLEDSOE |
| Credential | M.D. |
| Practice Address |
1072 N Liberty Street Ste 203 Boise ID 83701 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642 |
| Practice Telephone | 2083025800 |
| Practice Fax Number | 2083025855 |
| Mailing Telephone | 2083025800 |
| Mailing Fax Number | 2083025855 |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-07-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | M-14080 | ID | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 10077801-8905 | UT | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 10077801-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
1072 N LIBERTY STREET STE 203 |
| City | BOISE |
| State | ID |
| Zip Code | 83701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386612414 | Johnny Bert Green | Surgery | 1072 N Liberty Street, Suite 201, Boise, ID 83704 | 2006-03-14 |
| 1760903363 | Sheev Indravadan Dattani | Surgery | 1072 N Liberty Street, Ste 201, Boise, ID 83704 | 2017-07-05 |
| 1003288648 | Brittany Peeler | Physician Assistant | 1072 N Liberty Street, Ste 303, Boise, ID 83704 | 2015-10-22 |
| 1861861841 | Tess Weidner | Midwife | 1072 N Liberty Street, Ste 100, Boise, ID 83704 | 2015-09-19 |
| 1194127472 | Anna Hoskins | Physician Assistant | 1072 N Liberty Street, Ste 201, Boise, ID 83704-8708 | 2014-09-18 |
| 1770857021 | Wendi Holmes | Registered Nurse | 1072 N Liberty Street, Ste 100, Boise, ID 83704 | 2012-03-05 |
| 1316258510 | Bradley Grant Bishop | Pediatrics | 1072 N Liberty Street, Ste 203, Boise, ID 83704 | 2010-06-23 |
| 1265651566 | Ondrej Choutka | Neurological Surgery | 1072 N Liberty Street, Ste 303, Boise, ID 83704 | 2007-04-25 |
| 1750430617 | Adrian J Curnow | Surgery | 1072 N Liberty Street, Ste 201, Boise, ID 83704-8708 | 2007-01-09 |
| 1821150285 | Shauna Williams | Colon & Rectal Surgery | 1072 N Liberty Street, Suite 201, Boise, ID 83704 | 2006-12-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538603667 | Cook Behavioral Health LLC | Community/Behavioral Health | 123 Mcclure Avenue, Nampa, ID 83701 | 2016-12-08 |
| 1942448873 | Kathryn Anne Anderson | Counselor | 600 N Robbins Rd., Boise, ID 83701 | 2009-01-30 |
| 1700814787 | James W Smith | Internal Medicine | 287 W Jefferson St, Boise, ID 83701 | 2006-06-29 |
| 1376860577 | Jon Verdun | Counselor | 2607 Kerr Street, Boise, ID 83701-0357 | 2010-04-27 |
| 1578676714 | Dudley David Blake | Psychologist | Boise Va Medical Center, 500 West Fort Street, Boise, ID 83701-4598 | 2006-08-15 |
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437577483 | Kaitlin Burke | Pediatrics | 100 E Idaho St Ste 401, Boise, ID 83712-6267 | 2014-04-06 |
| 1780918748 | Jerome Anthony Hirschfeld | Pediatrics | 3101 E Nature Dr, Boise, ID 83706-6921 | 2009-09-23 |
| 1306020086 | Ann Catherine Miller | Pediatrics | 6348 Emerald St, Boise, ID 83642-2376 | 2007-12-18 |
| 1851588644 | Richard Epes Rainey | Pediatrics | 2100 N Larch St, Boise, ID 83706-1022 | 2007-09-26 |
| 1265544894 | Julie S Kikuchi | Pediatrics | 121 E Fort St, Boise, ID 83712-6322 | 2006-08-31 |
| 1174544829 | Allyson Ann Vansteenbergen | Pediatrics | 13960 W. Wainwright Dr., Suite B, Boise, ID 83713 | 2006-07-21 |
| 1609805779 | Ada Pediatrics, P.a. | Pediatrics | 650 N Cole Rd, Boise, ID 83704-9117 | 2006-07-01 |
| 1487693099 | John P Jambura | Pediatrics | 7722 Ustick Rd, Boise, ID 83704-5845 | 2006-06-06 |
| 1730131905 | Angella M Zieba | Pediatrics | 6348 W Emerald St, Boise, ID 83704-8732 | 2006-05-16 |
| 1194773804 | Ben H. Godfrey | Pediatrics | 450 W State St, Suite 100, Boise, ID 83702-6056 | 2006-05-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.