MRS. JEANNETTE E JAIN (NPI# 1154311199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154311199 |
| Entity Type | Individual |
| Full Name | MRS. JEANNETTE E JAIN |
| Other Name | JEANNETTE E BENNETT |
| Credential | M.D. |
| Practice Address |
215 E Hawaii Ave Nampa ID 83686-6011 |
| Practice Telephone | 2084685930 |
| Practice Fax Number | 2084633044 |
| Mailing Telephone | 2084633000 |
| Mailing Fax Number | 2084633034 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2017-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | M8205 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806061800 | 05 | |
| ID | RAILROAD MEDICARE | 080036991 | 01 |
| ID | HEALTHY CONNECTIONS | 806353400 | 01 |
| ID | BLUE SHIELD | 000010032978 | 01 |
| ID | BLUE CROSS | 42507 | 01 |
| Street Address |
215 E HAWAII AVE |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-6011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740668 | Peter Stevan Jerome | Internal Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-06-14 |
| 1174145809 | Carolyn Knackstedt | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1609498336 | Houston Reynolds | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1427670157 | Ali Sup | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1710509443 | Rory Hawker | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1689295180 | Patricia J Funkhouser | Nurse Practitioner | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-06 |
| 1275169252 | Ashley Whitlow | Nurse Practitioner | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-03-21 |
| 1669002721 | Nicole Webb | Physician Assistant | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-01-16 |
| 1548824964 | Catherine Heil | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2019-05-01 |
| 1174187587 | Mark Dahle | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2019-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053301911 | Thomas J Hammer | Pediatrics | 1209 N Jacob Allcott Way, Nampa, ID 83687 | 2005-10-24 |
| 1790786515 | Mario Brus | Pediatrics | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2005-08-02 |
| 1285925644 | Amanda King Mason | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686 | 2011-04-20 |
| 1831304526 | Preston S Omer | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2007-05-14 |
| 1386744910 | Alicia Mary Suski | Pediatrics | 207 1st St S, Nampa, ID 83651-3703 | 2006-09-24 |
| 1386616431 | Michael B Aldous | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2006-02-03 |
| 1154311892 | Joseph L Papiez | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-25 |
| 1932198967 | Richard Aguilar | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-21 |
| 1639169626 | Deanna M Andrews | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-21 |
| 1871588632 | Michael J Wheaton | Pediatrics | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2005-09-16 |
| Find all providers in NAMPA | ||||
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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.