NORTH CANYON MEDICAL CENTER, INC (NPI# 1184932584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184932584 |
| Entity Type | Organization |
| Organization Name | NORTH CANYON MEDICAL CENTER, INC |
| Other Organization Name | NORTH CANYON MEDICAL CENTER |
| Practice Address |
267 N Canyon Dr Gooding ID 83330-5500 |
| Practice Telephone | 2089344433 |
| Mailing Telephone | 2089344433 |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2018-04-24 |
| Authorized Official Name | MS. JOYCE ASTLE (PATIENT FINANCIAL DIRECTOR) |
| Authorized Official Telephone | 2089344433 |
| Is Organization Subpart | Y |
| Parent Organization Name | EMERGENCY MEDICINE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
363AM0700X | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1609046671 | 05 |
| Other Name | Type Code |
|---|---|
| North Canyon Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558679951 | North Canyon Medical Center, Inc | Specialist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2010-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH CANYON MEDICAL CENTER, INC. | 267 N Canyon Dr, Gooding, ID 83330-5500 |
| Street Address |
267 N CANYON DR |
| City | GOODING |
| State | ID |
| Zip Code | 83330-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053316786 | Guy Eric Grooms | Specialist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2005-06-17 |
| 1841800943 | Charles Bryan Simpson | Emergency Medical Technician, Paramedic | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2020-08-04 |
| 1619469525 | North Canyon Medical Center, Inc. | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-06-06 |
| 1871098137 | Amanda Paige Braga | Social Worker | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-28 |
| 1497259378 | Francisca O Mendez | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-23 |
| 1740783125 | Susan A. Ormond | Dietitian, Registered | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| 1538662895 | Mercedes Diaz | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| 1255834685 | Rosa Yuriko Saucedo | Nurse's Aide | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1235632662 | Anali Santos | Nurse's Aide | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1083117402 | Tammy Jo Dayley | Technician/Technologist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1083959332 | Lydia Jo Missal | Counselor | 1832 E. 1750 S., Gooding, ID 83330 | 2012-11-27 |
| 1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
| 1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
| 1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
| 1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
| 1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
| 1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| Find all providers in zip 83330 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003325937 | Matthew Frank Ivie | Physician Assistant | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2017-09-22 |
| 1831526854 | Associates In Family Practice | Physician Assistant | 425 Idaho St, Gooding, ID 83330-1258 | 2013-10-04 |
| 1700841277 | Robert H Anderson | Physician Assistant | 425 Idaho Street, Gooding, ID 83330 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217911 | David Jeffrey Hanson | Physician Assistant | 740 Mckinley Ave Ste 100, Kellogg, ID 83837-2693 | 2019-10-18 |
| 1871060681 | Travis Henman | Physician Assistant | 1404 Pomerelle Ave Ste 150, Burley, ID 83318-2012 | 2018-10-30 |
| 1952889685 | Cody Mattingly | Physician Assistant | 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 | 2018-08-03 |
| 1992174072 | Alexa Rhea | Physician Assistant | 2841 Juniper Dr Ste 2, Lewiston, ID 83501-4719 | 2015-09-18 |
| 1043689441 | Derek R Wynn | Physician Assistant | 607 W Main Street, Grangeville, ID 83530 | 2015-09-16 |
| 1407223274 | Michael Kenneth Wucinich | Physician Assistant | 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 | 2015-08-28 |
| 1811364177 | Ashley Laren Popadics | Physician Assistant | 1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 | 2015-08-21 |
| 1073915963 | Jessica Bishop | Physician Assistant | 1499 W Hays St, Boise, ID 83702-5029 | 2014-09-23 |
| 1447652813 | Jessea Camille Whitlow | Physician Assistant | 2392 Addison Ave E, Twin Falls, ID 83301-6745 | 2014-09-17 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
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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.