MICHELE B EBBERS (NPI# 1154358067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154358067 |
| Entity Type | Individual |
| Full Name | MICHELE B EBBERS |
| Credential | MD |
| Practice Address |
305 E Jefferson St Boise ID 83712-6273 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083816196 |
| Practice Fax Number | 2083816199 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | 2006-00886 | NC | Allopathic & Osteopathic Physicians |
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
M11717 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
305 E JEFFERSON ST |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962491415 | Lynn M Luginbuhl | Pediatrics | 305 E Jefferson St, Boise, ID 83712-6273 | 2005-10-18 |
| 1366060147 | Bailey Severe | Genetic Counselor, MS | 305 E Jefferson St, Boise, ID 83712-6231 | 2020-07-08 |
| 1033748124 | Kody Michael Duclos | Dietitian, Registered | 305 E Jefferson St, Boise, ID 83712-6231 | 2020-04-02 |
| 1568826204 | Kelsy Newton | Psychologist | 305 E Jefferson St, Boise, ID 83712-6273 | 2016-04-08 |
| 1912272014 | Sean Timpane | Pediatrics | 305 E Jefferson St, Boise, ID 83712-6231 | 2012-03-21 |
| 1023306966 | Paul Christian Neville | Optometrist | 305 E Jefferson St, Boise, ID 83712-6273 | 2011-07-13 |
| 1699071217 | Samantha Cragg | Physical Medicine & Rehabilitation | 305 E Jefferson St, Boise, ID 83712-6231 | 2011-01-28 |
| 1891005716 | Malia Lynn Frazier | Nurse Practitioner | 305 E Jefferson St, Boise, ID 83712-6273 | 2010-10-13 |
| 1437467644 | Jaeger A Ashton | Nurse Practitioner | 305 E Jefferson St, Boise, ID 83712-6273 | 2010-09-22 |
| 1801059209 | Cheryl Higer | Dentist | 305 E Jefferson St, Boise, ID 83712-6273 | 2008-07-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235675364 | University of Utah Pediatric Services | Urology | 1645 Pancheri Dr, Idaho Falls, ID 83402-3169 | 2017-01-12 |
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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.