EYE CLINIC OF IDAHO FALLS,PA (NPI# 1093911133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093911133 |
| Entity Type | Organization |
| Organization Name | EYE CLINIC OF IDAHO FALLS,PA |
| Practice Address |
530 S Holmes Ave Idaho Falls ID 83401-4751 |
| Mailing Address |
Po Box 2410 Idaho Falls ID 83403-2410 |
| Practice Telephone | 2085293937 |
| Practice Fax Number | 2085244380 |
| Mailing Telephone | 2085293937 |
| Mailing Fax Number | 2085244380 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2011-09-15 |
| Authorized Official Name | DR. DAVID R ANDERSON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2085293937 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | M3793 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003572200 | 05 | |
| ID | 00240930 | 05 | |
| ID | INDIVIDUAL NPI | 1205974136 | 01 |
| Street Address |
530 S HOLMES AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-4751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205974136 | David Ray Anderson | Ophthalmology | 530 S Holmes, Idaho Falls, ID 83403-2410 | 2007-02-02 |
| 1275685513 | Peter Carl Zimmerman | Ophthalmology | 1449 E 17th Street, Idaho Falls, ID 83404-6236 | 2007-01-17 |
| 1063563823 | Matthew P Traynor | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404 | 2007-01-16 |
| 1861507857 | Aaron Jon Affleck | Ophthalmology | 2900 Valencia Dr, Idaho Falls, ID 83404-7594 | 2006-08-20 |
| 1144335290 | Gary Wayne Wallace | Ophthalmology | 2295 Coronado Street, Idaho Falls, ID 83404 | 2006-08-20 |
| 1922072586 | Eric K Romriell | Ophthalmology | 2025 E 17th St, Idaho Falls, ID 83404 | 2006-02-13 |
| 1487041380 | Samuel Welling Beckstead | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404-4951 | 2015-04-20 |
| 1932544111 | Jason Gerald Hooton | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404 | 2013-05-01 |
| 1790052603 | Premier Eye Care of Eastern Idaho Pllc | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404 | 2011-11-20 |
| 1710111224 | Kyle G Thompson | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404-6236 | 2009-05-12 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on EYE CLINIC OF IDAHO FALLS,PA.
| 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.