DR. CRAIG JENSEN (NPI# 1164893202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164893202 |
| Entity Type | Individual |
| Full Name | DR. CRAIG JENSEN |
| Credential | O.D. |
| Practice Address |
90 Hope Dr Bldg 6000 Mountain Home Afb ID 83648 |
| Mailing Address |
90 Hope Dr Bldg 6000 Mountain Home Afb ID 83648-1062 |
| Practice Telephone | 2088287250 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2018-08-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 9552945-9934 | UT | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487710935 | Craig C. Jensen | Psychologist | 6803 164th Pl Sw, Edmonds, WA 98026-4918 | 2006-12-29 |
| 1841367661 | Craig Eugene Jensen | Chiropractor | 1316 Park St, Commerce, TX 75428-2647 | 2006-11-29 |
| 1437295987 | Craig C Jensen | Counselor | 1601 2nd Ave N, Suite 616, Great Falls, MT 59401-3259 | 2007-01-30 |
| 1891875159 | Craig Jensen | Pediatrics | 6701 Fannin St, Houston, TX 77030-2316 | 2006-10-17 |
| 1336233717 | Craig A Jensen | Internal Medicine | 1100 Central Ave Se, 4th Floor Hospitalists Office, Albuquerque, NM 87106-4930 | 2006-10-03 |
| 1811092216 | Craig R Jensen | Anesthesiology | 400 C St, Salt Lake City, UT 84143-1005 | 2006-09-13 |
| Street Address |
90 HOPE DR BLDG 6000 |
| City | MOUNTAIN HOME AFB |
| State | ID |
| Zip Code | 83648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023007846 | Craig Loyd Folsom | Dentist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2005-10-14 |
| 1598378614 | Whitney Mark Galloway | Physician Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2020-08-28 |
| 1457908360 | Le Ann Marie Egan | Psychologist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-26 |
| 1639725286 | Kadeesh Mcnaught | Dental Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-09 |
| 1982259875 | David J Emert | Dental Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-07 |
| 1568016103 | Dylan Broadwater | Pharmacist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-07-31 |
| 1700381175 | Erin Siebert | Military Health Care Provider | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2018-03-28 |
| 1538684915 | Emily Frieda Foxton | Physical Therapist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2017-08-07 |
| 1598298135 | Zack Hunter | Military Health Care Provider | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2017-04-11 |
| 1922456979 | Jakob Kamilow | Counselor | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851528392 | Amy Jo Glover | Military Health Care Provider | 90 Hope Dr. Bldg 6000, Mountain Home, ID 83648 | 2009-06-11 |
| 1306051065 | Thomas Michael Smith | Social Worker | 90 Hope Dr Bldg 1900, Mountain Home Afb, ID 83648 | 2007-05-14 |
| 1316005143 | Ronald Wesley Bailey | Radiology | Mountain Home Afb Medical Group, 90 Hope Drive, Building 6000, Mountain Home Afb, ID 83648 | 2006-12-05 |
| 1992780597 | Randall Jay Moore | Preventive Medicine | 366mdg/sgpf, 90 Hope Drive; Bldg 6000, Mountain Home Afb, ID 83648 | 2005-12-07 |
| 1356325666 | Joseph Carroll Skinner Jr. | Nurse Anesthetist, Certified Registered | 366 Mdos, Sgosa, 90 Hope Drive, Mountain Home Afb, ID 83648 | 2005-11-30 |
| 1477547271 | Ron Stumbo | Pharmacist | Mountain Home Afb, Mountain Home Afb, ID 83648 | 2005-09-07 |
| 1154315943 | Georgette Ann Trezvant | Social Worker | 366 Medical Operations Squadron, 90 Hope Drive, Bldg 6000, Mt. Home Air Force Base, ID 83648 | 2005-09-07 |
| 1265948897 | Alyse Marie Denittis | Physician Assistant | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-12-19 |
| 1891224473 | Jared Getzlaff | Military Health Care Provider | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-06-07 |
| 1548796527 | Derek J Dutson | Dentist | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-05-11 |
| Find all providers in zip 83648 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154604692 | Matthew Phillip Polster | Optometrist | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2011-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536362 | Daniel & Max, LLC | Optometrist | 1405 N Milwaukee St, Boise, ID 83704-8400 | 2020-10-20 |
| 1326669920 | Clear Eyes Optometric Care, Pllc | Optometrist | 7950 Horseshoe Bend Rd Ste 101, Boise, ID 83714-3809 | 2020-05-05 |
| 1538792551 | Eyes On Meridian LLC | Optometrist | 119 E Calderwood Dr, Meridian, ID 83642-7482 | 2020-02-18 |
| 1962067538 | Eyecare Associates of Kuna | Optometrist | 943 N Linder Rd Ste 102, Kuna, ID 83634-3395 | 2019-05-08 |
| 1700440948 | Mobilitycares LLC | Optometrist | 14340 Salmon River Rd, Caldwell, ID 83607-7813 | 2019-04-23 |
| 1255898292 | Kreed Bowman Od Pllc | Optometrist | 250 S Skyline Dr Ste 6, Idaho Falls, ID 83402-3292 | 2019-02-26 |
| 1972089514 | John Wesley Porter | Optometrist | 3363 Merlin Dr, Idaho Falls, ID 83404-7405 | 2018-07-17 |
| 1467945873 | Blake Bingham | Optometrist | 1700 W Karcher Rd, Nampa, ID 83651-1531 | 2018-06-11 |
| 1396238689 | Daniel Leo Adams | Optometrist | 8220 N Cornerstone Dr Ste A, Hayden, ID 83835-8683 | 2018-06-11 |
| 1598258055 | Daniel Christopher Kunz | Optometrist | 4191 Poleline Rd Ste C, Pocatello, ID 83202-2402 | 2018-06-10 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME AFB |
| Zip Code | 83648 |
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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.