MATTHEW WILSON (NPI# 1063807097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063807097 |
| Entity Type | Individual |
| Full Name | MATTHEW WILSON |
| Credential | MD |
| Practice Address |
300 S 23rd St Boise ID 83702-9100 |
| Mailing Address |
Po Box 9 Nampa ID 83653-0009 |
| Practice Telephone | 2083443512 |
| Practice Fax Number | 2084665359 |
| Mailing Telephone | 2084674431 |
| Mailing Fax Number | 2084665359 |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2019-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M-14743 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211231 | Matthew Wilson | Homemaker | 5515 Plain City Georgesville Rd, Plain City, OH 43064-8825 | 2020-09-29 |
| 1821655986 | Matthew Wilson | Student in an Organized Health Care Education/Training Program | 322 E Prentiss St Apt 502, Iowa City, IA 52240-1766 | 2019-05-23 |
| 1003472853 | Matthew Francis Wilson | Social Worker | 417 Gettysburg St Ste 200, Pittsburgh, PA 15206-4529 | 2019-05-17 |
| 1629492798 | Matthew James Wilson | Student in an Organized Health Care Education/Training Program | 725 W Maple St, Johnson City, TN 37604-6507 | 2014-02-10 |
| 1568752392 | Matthew Steven Wilson | Orthopaedic Surgery | 834 Chestnut Street, Suite G-114, The Philadelphia Hand Center, Philadelphia, PA 19107 | 2011-04-13 |
| 1174839054 | Matthew C Wilson | Family Medicine | Schneck Primary Care - Jackson Park, 1124 Medical Place, Seymour, IN 47274 | 2010-08-30 |
| 1184892531 | Matthew J Wilson | Technician, Other | 119 Beal Pkwy Se, Suite 101, Fort Walton Beach, FL 32548-5386 | 2008-02-19 |
| 1003093600 | Matthew J. Wilson | Internal Medicine | 755 Mt Vernon Hwy, Suite 530, Atlanta, GA 30328 | 2008-01-25 |
| 1770193732 | Matthew Dwight Wilson | Case Manager/Care Coordinator | 2250 N Airport Rd, Weatherford, OK 73096-3351 | 2020-08-05 |
| 1972128643 | Matthew Hall Wilson | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| Street Address |
300 S 23RD ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-9100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437132479 | Vivek Kantayya | Family Medicine | 300 S 23rd St, Boise, ID 83702-9100 | 2005-11-23 |
| 1639716236 | Wayne Nubile | Counselor | 300 S 23rd St, Boise, ID 83702-9100 | 2019-12-03 |
| 1487299129 | Dusty L Orr | Social Worker | 300 S 23rd St, Boise, ID 83702-9100 | 2019-11-15 |
| 1902459266 | Melissa Adele Wren Perry | Nurse Practitioner | 300 S 23rd St, Boise, ID 83702-9100 | 2019-07-16 |
| 1235613688 | Devin R Pugmire | Peer Specialist | 300 S 23rd St, Boise, ID 83702-9100 | 2018-09-21 |
| 1386128726 | Samantha Joseph | Social Worker | 300 S 23rd St, Boise, ID 83702-9100 | 2018-09-21 |
| 1023599586 | Joseph P Digrazia | Counselor | 300 S 23rd St, Boise, ID 83702-9100 | 2018-08-23 |
| 1790263234 | Stephanie M. Meeks | Social Worker | 300 S 23rd St, Boise, ID 83702-9100 | 2018-08-06 |
| 1205322310 | Brian Lee Collins | Social Worker | 300 S 23rd St, Boise, ID 83702-9100 | 2018-07-02 |
| 1972982437 | Matthew Todd Posluszny | Social Worker | 300 S 23rd St, Boise, ID 83702-9100 | 2015-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790269389 | Erin Michelle Love Mcdermott | Family Medicine | 2402 W Jefferson St, Boise, ID 83702-4811 | 2018-09-19 |
| 1336656040 | Functional Medicine of Idaho PC | Family Medicine | 3858 N Garden Center Way Ste 100, Boise, ID 83703-5008 | 2018-01-03 |
| 1922456870 | Daniel Luftig | Family Medicine | 1041 S Dale St Apt 302, Boise, ID 83706-7641 | 2016-06-01 |
| 1942676598 | Robert F. Smith, Md, Pllc | Family Medicine | 320 N Collins Rd, Boise, ID 83702-4519 | 2015-08-18 |
| 1861827222 | Treasure Valley Neuropathy Relief Center PC | Family Medicine | 1755 N Westgate Dr, Suite 200, Boise, ID 83704-7174 | 2013-09-04 |
| 1205272986 | Shahla Walizada | Family Medicine | 2141 E Parkcenter Blvd, Samg Bhp Family Medicine, Boise, ID 83706 | 2013-05-21 |
| 1891057246 | Kara Mackenzie Kuntz | Family Medicine | 5966 W Curtisian Road, Boise, ID 83704 | 2012-06-12 |
| 1922366707 | Cottonwood Family Medicine | Family Medicine | 100 Cottonwood Court, Suite 150, Boise, ID 87616 | 2012-04-30 |
| 1720377476 | Steven Schneider | Family Medicine | 3775 W Quail Hollow Dr, Boise, ID 83703-3869 | 2011-04-04 |
| 1922311042 | Amber Vania | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2010-07-18 |
| Find all providers in BOISE | ||||
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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.