DR. LARRY DAVID BOMSTA (NPI# 1114086048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114086048 |
| Entity Type | Individual |
| Full Name | DR. LARRY DAVID BOMSTA |
| Credential | MD |
| Practice Address |
467 Washington St Montpelier ID 83254-1544 |
| Practice Telephone | 2088470072 |
| Practice Fax Number | 2088470077 |
| Mailing Telephone | 2088470072 |
| Mailing Fax Number | 2088470077 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5549 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | 5549-1 | 01 |
| ID | BLUE SHIELD OF IDAHO | 000010004905 | 01 |
| Street Address |
467 WASHINGTON ST |
| City | MONTPELIER |
| State | ID |
| Zip Code | 83254-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194849877 | Trevor George Robinson | Obstetrics & Gynecology | 467 Washington St, Montpelier, ID 83254-1544 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366597866 | Joseph F Decker Professional Corp | Surgery | 164 S 5th, Montpelier, ID 83254 | 2007-01-24 |
| 1447311139 | Bear Lake County | Ambulance | 385 Cemetary Road, Montpelier, ID 83254 | 2006-12-13 |
| 1073685343 | Steven D Hammond | Dentist | 455 Washington St, Montpelier, ID 83254 | 2006-11-14 |
| 1982610549 | Dorian S Grunig | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-08-01 |
| 1104840412 | Harold A Olson | Pharmacist | 765 Washington St., Montpelier, ID 83254 | 2006-07-27 |
| 1033603345 | Sydnie M Hobbs | Nurse Practitioner | 152 S 4th St, Montpelier, ID 83254 | 2018-06-20 |
| 1265505705 | Robert D Degnan | Obstetrics & Gynecology | 742 Washington St, Montpelier, ID 83254 | 2006-11-15 |
| 1952491714 | Gary Scott Griffin | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-10-13 |
| 1013027952 | Matthew Brinton Stevens | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| 1265542435 | Reset P.a. | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| Find all providers in zip 83254 | ||||
| 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 |
|---|---|---|---|---|
| 1750559308 | Micheal Friedman | Family Medicine | 146 Main St Unit 6, Montpelier, VT 05602-2920 | 2008-02-18 |
| 1952497810 | Clay I. Campbell | Family Medicine | 166 So 5th St, Montpelier, ID 83254-1557 | 2006-10-05 |
| 1720029564 | Clarence A Bell | Family Medicine | 909 East Snyder Avenue, Montpelier, OH 43543-1271 | 2006-06-10 |
| 1235176678 | R O Kanney | Family Medicine | 935 E Snyder Ave, Montpelier, OH 43543-1251 | 2006-06-02 |
| 1538129184 | Lori J Skidmore | Family Medicine | 121 E High St, Montpelier, IN 47359-1105 | 2006-03-27 |
| 1477916062 | Emily Greer Jones | Family Medicine | 156 Main St, Montpelier, VT 05602-2702 | 2016-03-31 |
| 1699057166 | Bear Lake County Memorial Hospital | Family Medicine | 465 Washington St, Montpelier, ID 83254-1544 | 2011-09-12 |
| 1861620262 | Lance A Hansen | Family Medicine | 465 Washington St, Montpelier, ID 83254-1544 | 2009-06-24 |
| 1366677759 | Trevor Dean Jacobson | Family Medicine | 166 S 5th St, Montpelier, ID 83254-4959 | 2009-05-28 |
| 1407010630 | Mark Samuel Mabus | Family Medicine | 935 E Snyder Ave, Montpelier, OH 43543-1251 | 2008-07-16 |
| Find all providers in MONTPELIER | ||||
| City | MONTPELIER |
| Zip Code | 83254 |
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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.