JACK C CHAFFIN JR. (NPI# 1104867662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104867662 |
| Entity Type | Individual |
| Full Name | JACK C CHAFFIN JR. |
| Credential | MD |
| Practice Address |
1055 N Curtis Rd Boise ID 83706-1309 |
| Mailing Address |
Po Box 9589 Boise ID 83707-4589 |
| Practice Telephone | 2083672152 |
| Mailing Telephone | 2084728109 |
| Mailing Fax Number | 2084728172 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2011-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
M8872 | ID | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
M8872 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806728500 | 05 |
| Street Address |
1055 N CURTIS RD |
| City | BOISE |
| State | ID |
| Zip Code | 83706-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235122284 | Christopher Jay Sjoberg | Nurse Practitioner | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2005-08-24 |
| 1689287021 | Brian Jones | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-08-25 |
| 1346868759 | Rhianna Wallace | Occupational Therapist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-12 |
| 1447877824 | Chelsea Zipse | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-01 |
| 1770105181 | Eric Munoz Quiroz | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-05-08 |
| 1477197036 | Megan Lenkersdorfer | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-11-06 |
| 1104477967 | Paul David Cochran | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-24 |
| 1649820259 | Monica Marie Mclain | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-16 |
| 1619526613 | Calan Szmyd | Genetic Counselor, MS | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-11 |
| 1922650613 | Allison A. Martinez | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
| 1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| Find all providers in zip 83706 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578674560 | Daniel Louis Toweill | Pathology | 1151 W. Miller St., Boise, ID 83702-6965 | 2006-08-31 |
| 1821093527 | Michael J Myhre | Pathology | 1151 Miller St, Boise, ID 83702-6965 | 2005-06-17 |
| 1215253240 | Elizabeth M Williams | Pathology | 190 E Bannock St, Boise, ID 83712-6241 | 2010-04-15 |
| 1386960466 | Karen Ann Johnson | Pathology | 190 E Bannock St, Boise, ID 83712-6241 | 2010-04-14 |
| 1013168830 | Brian John Hall | Pathology | 999 N Curtis Rd, Ste 117, Boise, ID 83706-1336 | 2008-10-10 |
| 1821261918 | Mark Owen Moore | Pathology | 999 N Curtis Rd, Suite 117, Boise, ID 83706-1336 | 2008-04-09 |
| 1679769350 | Carl T Koenen | Pathology | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2007-09-17 |
| 1578573242 | Frederick W Bauer | Pathology | 500 W Fort St, Boise, ID 83702-4501 | 2006-08-08 |
| 1386677524 | St Alphonsus Professional Medical Services LLC | Pathology | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2006-07-09 |
| 1396785531 | Edward J Kim | Pathology | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2006-06-07 |
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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.