MR. STEPHEN J FRELLY (NPI# 1114966959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114966959 |
| Entity Type | Individual |
| Full Name | MR. STEPHEN J FRELLY |
| Credential | PA |
| Practice Address |
1618 S Millenium Way Ste 100 Meridian ID 83642-6457 |
| Practice Telephone | 2088843376 |
| Practice Fax Number | 2088840858 |
| Mailing Telephone | 2088843376 |
| Mailing Fax Number | 2088840858 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA495 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1618 S MILLENIUM WAY STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-6457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558789560 | Brian Spencer Hoyt | Dermatology | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2014-04-07 |
| 1568880995 | Ryan Bruce Thorpe | Dermatology | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2014-04-02 |
| 1740628023 | Daniel Seth Winchester | Dermatology | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2013-06-10 |
| 1922309848 | Juliann Claire Visser | Physician Assistant | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2010-11-09 |
| 1417184409 | Mark Noble Schwendiman | Dermatology | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2009-06-17 |
| 1285803445 | David James Barclay II | Physician Assistant | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2008-02-21 |
| 1518973338 | Ada West Dermatology, P.C. | Dermatology | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2006-08-01 |
| 1417999657 | Tiffany Mccray | Physician Assistant | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2006-06-12 |
| 1013956853 | Alexander J Arhets | Physician Assistant | 1618 S Millenium Way Ste 100, Meridian, ID 83642-6457 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164305 | Tessie Mari Mcinnally | Physician Assistant | 3015 E Magic View Dr # 115, Meridian, ID 83642-3743 | 2019-09-29 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1790224905 | Yustina Nader Rafla | Physician Assistant | 520 S Eagle Rd Ste 1243, Meridian, ID 83642-6355 | 2017-02-21 |
| 1295163160 | Kalyn Baisley | Physician Assistant | 360 E Montvue Dr # 100, Meridian, ID 83642-6318 | 2013-10-31 |
| 1063601177 | Richard A Trump | Physician Assistant | 3015 E Magic View Dr Ste 120, Meridian, ID 83642-3750 | 2007-10-15 |
| 1740476969 | Laura B Allen | Physician Assistant | 1618 Millenium Way Ste 100, Meridian, ID 83642-6457 | 2007-09-20 |
| 1568499713 | Brian D Friedt | Physician Assistant | 1618 S. Millennium Way, Suite 100, Meridian, ID 83642-6457 | 2006-06-26 |
| 1114964616 | Amber M Vickers | Physician Assistant | 1623 S. Wells Avenue, Meridian, ID 83642 | 2006-06-01 |
| 1336196757 | Kathleen Rose Nielsen | Physician Assistant | 3041 E Copper Point Dr, Meridian, ID 83642-1740 | 2006-05-30 |
| 1124092101 | Albert Donald Bickford | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642-1026 | 2006-02-15 |
| Find all providers in MERIDIAN | ||||
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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.