COMMUNITY CARE PLLC (NPI# 1184647307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184647307 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE PLLC |
| Practice Address |
72 E Main St Rexburg ID 83440-1926 |
| Practice Telephone | 2083591770 |
| Practice Fax Number | 2083591780 |
| Mailing Telephone | 2083591770 |
| Mailing Fax Number | 2083591780 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RYAN PETERSON (CEO) |
| Authorized Official Telephone | 2085258448 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326061565 | Community Care Pllc | Family Medicine | 2725 Channing Way, Idaho Falls, ID 83404-7510 | 2006-07-26 |
| 1205846425 | Community Care Pllc | Family Medicine | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2006-08-09 |
| 1952324188 | Community Care Pllc | Family Medicine | 167 E 1st S, Rigby, ID 83442-1401 | 2006-07-26 |
| Street Address |
72 E MAIN ST |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-1926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366488926 | Trent E Shaw | Physician Assistant | 72 E Main St, Rexburg, ID 83440-1926 | 2006-06-21 |
| 1659914802 | Mountain View Hospital LLC | Family Medicine | 72 E Main St, Rexburg, ID 83440-1926 | 2019-10-21 |
| 1740554237 | Community Care Rexburg LLC | Nurse Practitioner | 72 E Main St, Rexburg, ID 83440-1926 | 2012-02-29 |
| 1972549137 | David F Daniels | Family Medicine | 72 E Main St, Rexburg, ID 83440-1926 | 2006-06-22 |
| 1821034562 | William Brad Speakman | Family Medicine | 72 E Main St, Rexburg, ID 83440-1926 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768490 | Henry's Fork Surgery Center Pllc | Clinic/Center | 23 Sawtelle Ave, Rexburg, ID 83440 | 2020-04-08 |
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| Find all providers in zip 83440 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790244424 | Destin Thayne Bep Inc | Family Medicine | 859 S Yellowstone Hwy Ste 304, Rexburg, ID 83440-5294 | 2019-03-12 |
| 1649478645 | Rex E. Head | Family Medicine | 1980 Cody Ln, Rexburg, ID 83440-4360 | 2007-07-11 |
| 1285785782 | Gary R Sena | Family Medicine | 420 E 4th N, Rexburg, ID 83440-5390 | 2007-01-13 |
| 1770684003 | Jacob Kimball Curtis | Family Medicine | 72 S 1st E, Rexburg, ID 83440-1902 | 2006-09-26 |
| 1780797712 | Jeffrey Gardner Hopkin | Family Medicine | 32 W 1st S, Rexburg, ID 83440-1810 | 2006-08-16 |
| 1114957362 | Kelly L Dustin | Family Medicine | 21 Winn Dr, Rexburg, ID 83440-5277 | 2006-07-04 |
| 1750329629 | Scott Russell Hardy | Family Medicine | 37 S 2nd E, Rexburg, ID 83440-1906 | 2006-06-03 |
| 1336140664 | Joseph Watson | Family Medicine | 393 E 2nd N, Rexburg, ID 83440-1605 | 2005-08-09 |
| 1659914802 | Mountain View Hospital LLC | Family Medicine | 72 E Main St, Rexburg, ID 83440-1926 | 2019-10-21 |
| 1346709821 | Eric Lee Brown | Family Medicine | 859 S Yellowstone Hwy Ste 304, Rexburg, ID 83440-5294 | 2019-03-14 |
| Find all providers in REXBURG | ||||
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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.