BOISE MINOR EMERGENCY CENTER PA (NPI# 1114938909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114938909 |
| Entity Type | Organization |
| Organization Name | BOISE MINOR EMERGENCY CENTER PA |
| Practice Address |
2993 N Cole Rd Boise ID 83704-5977 |
| Practice Telephone | 2083780400 |
| Practice Fax Number | 2083787529 |
| Mailing Telephone | 2083780400 |
| Mailing Fax Number | 2083787529 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GARY CANOVA (OWNER) |
| Authorized Official Telephone | 2083780400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
2993 N COLE RD |
| City | BOISE |
| State | ID |
| Zip Code | 83704-5977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912945742 | John D Crites | Family Medicine | 2993 N Cole Rd, Boise, ID 83704-5977 | 2006-06-03 |
| 1770506826 | Kristine H Bowlden | Family Medicine | 2993 N Cole Rd, Boise, ID 83704-5977 | 2006-07-26 |
| 1265454680 | Gary Canova | Family Medicine | 2993 N Cole Rd, Boise, ID 83704-5977 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881074201 | Lindsey Wells | General Practice | 2537 W State St Ste 110, Boise, ID 83702-2200 | 2015-06-01 |
| 1265824312 | Drugshield Inc | General Practice | 3085 N Cole Rd, Ste 108, Boise, ID 83704-5968 | 2015-02-26 |
| 1487926564 | Boise Image Enhancement Centre, Inc. | General Practice | 9382 W Overland Rd, Boise, ID 83709-2505 | 2012-02-03 |
| 1780987164 | Optigenics LLC | General Practice | 1317 W River St, Boise, ID 83702-6857 | 2010-12-07 |
| 1932411576 | Isara Group Inc. | General Practice | 702 W Idaho St, Suite 1100, Boise, ID 83702-8901 | 2010-07-12 |
| 1205819950 | Kirk A. Campana | General Practice | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2005-11-28 |
| 1285262246 | Olivia Nicole Roehling | General Practice | 500 W Fort St, Mailstop #111r, Boise, ID 83702-4501 | 2020-03-27 |
| 1285971416 | Children's Home Society of Idaho | General Practice | 740 E Warm Springs Ave, Boise, ID 83712-6420 | 2013-01-08 |
| 1104179670 | Zldmd Pllc | General Practice | 6000 W Overland Rd, Boise, ID 83709-3013 | 2012-10-22 |
| 1639481286 | Nomsiri Group Inc | General Practice | 950 W Bannock St, Suite 1100, Boise, ID 83702-5999 | 2010-07-12 |
| 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.