RONNIE DANIEL MANTILLA (NPI# 1164785549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164785549 |
| Entity Type | Individual |
| Full Name | RONNIE DANIEL MANTILLA |
| Credential | M.D. |
| Practice Address |
700 W Ironwood Dr Ste 378 Coeur D Alene ID 83814-4401 |
| Mailing Address |
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 |
| Practice Telephone | 2086253555 |
| Practice Fax Number | 2086253556 |
| Mailing Telephone | 2086253555 |
| Mailing Fax Number | 2086253556 |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2020-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
M15022 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
700 W IRONWOOD DR STE 378 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083728430 | Robert Scoggins | Internal Medicine | 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814-4401 | 2006-08-19 |
| 1902267214 | Leah Bennett | Nurse Practitioner | 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814-4401 | 2016-03-14 |
| 1063856151 | Amanda Rose Liggett | Internal Medicine | 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814-4401 | 2013-04-19 |
| 1336433192 | Jeannette Zinggeler Berg | Internal Medicine | 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814-4401 | 2011-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063856151 | Amanda Rose Liggett | Internal Medicine | 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814-4401 | 2013-04-19 |
| 1932464989 | North Idaho Lung, Asthma and Critical Care, LLC. | Internal Medicine | 700 W Ironwood Dr, Suite 336, Coeur D Alene, ID 83814-2656 | 2012-07-05 |
| 1336433192 | Jeannette Zinggeler Berg | Internal Medicine | 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814-4401 | 2011-06-08 |
| 1538452941 | Elizabeth Ellen Hankinson | Internal Medicine | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2011-05-17 |
| 1275663361 | Todd Christian Hoopman | Internal Medicine | 700 W Ironwood Dr, Ste 378, Coeur D Alene, ID 83814-4401 | 2007-03-07 |
| 1538205927 | David P York | Internal Medicine | 700 W Ironwood Dr, Suite 336, Coeur D Alene, ID 83814-2656 | 2007-01-30 |
| 1578609830 | Kevin J Chang | Internal Medicine | 700 W Ironwood Dr, Suite 336, Coeur D Alene, ID 83814-2656 | 2007-01-30 |
| 1144255639 | Kevin B Strait | Internal Medicine | 700 W Ironwood Dr, Suite 378, Coeur D Alene, ID 83814-2656 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407124753 | Idaho Falls Pulmonary Sleep & Critical Care Specialists | Internal Medicine | 2442 E 25th St, Idaho Falls, ID 83404-7549 | 2011-12-01 |
| 1831423557 | Idagem Services Inc | Internal Medicine | 1533 N Milwaukee St, Ste 321, Boise, ID 83704-8471 | 2009-09-28 |
| 1417102930 | Joshua David Holweger | Internal Medicine | 1075 N Curtis, Ste 200, Boise, ID 83706-1350 | 2008-11-25 |
| 1659407716 | Richard Keith Oehlschlager | Internal Medicine | 3036 Lakewood Way, Boise, ID 83706-5240 | 2007-02-25 |
| 1194861534 | Richard J Robinson | Internal Medicine | 700 West Ironwood Drive, Suite 336, Coeur D'alene, ID 83814-4485 | 2007-01-30 |
| 1013946391 | Janat E. O'donnell | Internal Medicine | 1075 N. Curtis Rd, Suite 200, Boise, ID 83706-1300 | 2006-06-30 |
| 1528002029 | Ronald F Fullmer | Internal Medicine | 570 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-06-15 |
| 1932169042 | Cary V. Jackson | Internal Medicine | 401 E Hawaii, Nampa, ID 83686 | 2006-03-23 |
| 1932191319 | Peter Lawrence Fort | Internal Medicine | 777 Hospital Way Ste 202, Pocatello, ID 83201-5175 | 2005-08-22 |
| 1932769700 | Gritman Medical Center Inc | Internal Medicine | 700 S Main St, Moscow, ID 83843-3046 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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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.