IDAHO EAR CLINIC LLC (NPI# 1154976983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154976983 |
| Entity Type | Organization |
| Organization Name | IDAHO EAR CLINIC LLC |
| Practice Address |
13900 W Wainwright Dr Ste 102 Boise ID 83713-5028 |
| Practice Telephone | 2089385823 |
| Practice Fax Number | 2089385306 |
| Mailing Telephone | 2089385823 |
| Mailing Fax Number | 2089385306 |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | JAMES V CRAWFORD (OWNER) |
| Authorized Official Telephone | 2089385823 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
Allopathic & Osteopathic Physicians |
| Street Address |
13900 W WAINWRIGHT DR STE 102 |
| City | BOISE |
| State | ID |
| Zip Code | 83713-5028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649253188 | Delray Maughan | Otolaryngology | 13900 W Wainwright Dr Ste 102, Boise, ID 83713-5028 | 2005-11-29 |
| 1548751563 | James V. Crawford, Md LLC | Otolaryngology | 13900 W Wainwright Dr Ste 102, Boise, ID 83713-5028 | 2018-05-24 |
| 1215904966 | James Vincent Crawford | Otolaryngology | 13900 W Wainwright Dr Ste 102, Boise, ID 83713 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 207YX0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otology & Neurotology |
| An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548751563 | James V. Crawford, Md LLC | Otolaryngology | 13900 W Wainwright Dr Ste 102, Boise, ID 83713-5028 | 2018-05-24 |
| 1215904966 | James Vincent Crawford | Otolaryngology | 13900 W Wainwright Dr Ste 102, Boise, ID 83713 | 2006-03-01 |
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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.