DR. GERALD A WOODWORTH (NPI# 1053341644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053341644 |
| Entity Type | Individual |
| Full Name | DR. GERALD A WOODWORTH |
| Credential | D.M.D. |
| Practice Address |
301 Scott Ave Rupert ID 83350-1800 |
| Mailing Address |
Po Box 338 Rupert ID 83350-0338 |
| Practice Telephone | 2084366406 |
| Practice Fax Number | 2084369678 |
| Mailing Telephone | 2084366406 |
| Mailing Fax Number | 2084369678 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D-1363 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | 6F696 | 01 |
| UNITED CONCORDIA | 560823 | 01 | |
| ID | DELTA DENTAL | 1363 | 01 |
| ID | REGENCE BLUESHIELD | 000010009632 | 01 |
| Street Address |
301 SCOTT AVE |
| City | RUPERT |
| State | ID |
| Zip Code | 83350-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497974141 | Doctors Garrard and Wayment Dentists Pllc | Dentist | 301 Scott Ave, Ste #3, Rupert, ID 83350-1800 | 2007-04-24 |
| 1679582498 | Robert P Wayment | Dentist | 301 Scott Ave, Ste#3, Rupert, ID 83350-5100 | 2006-08-08 |
| 1477582948 | Charle A Warren | Dentist | 301 Scott Ave, Rupert, ID 83350-1800 | 2006-06-30 |
| 1124056544 | John R Garrard | Dentist | 301 Scott Ave, Rupert, ID 83350-1800 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417349515 | Robbie Joe Carroll | Registered Nurse | 1024 8th Street, Family Health Services, Rupert, ID 83350 | 2015-02-26 |
| 1285921643 | Duane Broderick | Counselor | 2311 Parke Ave., Ste. 8, Burley, ID 83350 | 2011-07-06 |
| 1598798282 | Kerry W Saurey | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| 1093761694 | Family Health Services Corporation | Dental Hygienist | 402 6th St, Rupert, ID 83350 | 2006-05-25 |
| 1376531004 | Jeffrey Scott Swenson | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2005-10-06 |
| 1205312774 | Shawna M Mccaffrey | Nurse Practitioner | 1308 8th St, Rupert, ID 83350 | 2018-07-17 |
| 1386872810 | Brian R Muir | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2009-06-23 |
| 1083816334 | Cameron Mchan | Nurse Practitioner | 1308 8th St Ste 1, Rupert, ID 83350 | 2007-05-31 |
| 1134225956 | Margo Saunders | Specialist | 1308 8th St Ste 1, Rupert, ID 83350 | 2006-09-16 |
| 1619900305 | Don C Pates | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| Find all providers in zip 83350 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144230566 | Neal Johnson | Dentist | 115 W 100 S, Rupert, ID 83350-9125 | 2006-08-08 |
| 1124534433 | Nathan A Catmull Dds Pllc | Dentist | 502 8th St, Rupert, ID 83350-1417 | 2017-12-21 |
| 1457510042 | Nathan A Catmull | Dentist | 502 8th St, Rupert, ID 83350-1417 | 2008-06-09 |
| 1497914337 | John A Simpson Dds PC | Dentist | 502 8th St, Rupert, ID 83350-1417 | 2008-06-05 |
| 1477723955 | Magic Valley Family Dental | Dentist | 115 W 100 S, Rupert, ID 83350-9125 | 2008-03-11 |
| 1497974141 | Doctors Garrard and Wayment Dentists Pllc | Dentist | 301 Scott Ave, Ste #3, Rupert, ID 83350-1800 | 2007-04-24 |
| 1679582498 | Robert P Wayment | Dentist | 301 Scott Ave, Ste#3, Rupert, ID 83350-5100 | 2006-08-08 |
| 1477582948 | Charle A Warren | Dentist | 301 Scott Ave, Rupert, ID 83350-1800 | 2006-06-30 |
| 1124056544 | John R Garrard | Dentist | 301 Scott Ave, Rupert, ID 83350-1800 | 2006-06-28 |
| 1427097963 | John Arthur Simpson | Dentist | 502 8th St, Rupert, ID 83350-1417 | 2006-06-06 |
| Find all providers in RUPERT | ||||
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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.