FAMILY MEDICINE & MEDICINE (NPI# 1194136515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194136515 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICINE & MEDICINE |
| Practice Address |
380 Washington Ave Suite 204 Ketchum ID 83340-1575 |
| Mailing Address |
Po Box 1575 Ketchum ID 83340-1575 |
| Practice Telephone | 2087250900 |
| Practice Fax Number | 2087250901 |
| Mailing Telephone | 2087250900 |
| Mailing Fax Number | 2087250901 |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |
| Authorized Official Name | MRS. NANETTE FORD (PRESIDENT) |
| Authorized Official Telephone | 2087250900 |
| Authorized Official Credential | P.A.-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-126 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
380 WASHINGTON AVE SUITE 204 |
| City | KETCHUM |
| State | ID |
| Zip Code | 83340-1575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407190671 | Amanda J Allaire | Nurse Practitioner | 380 Washington Ave, Ketchum, ID 83340 | 2012-11-12 |
| 1396900742 | Kimberly A. Vorse Md PC | Clinic/Center | 380 Washington Ave, Suite 201, Ketchum, ID 83340 | 2008-07-25 |
| 1043242613 | Kimberly A Vorse | Internal Medicine | 380 Washington Ave, Suite 201, Ketchum, ID 83340-5000 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779606 | Rooted Womens Health | Occupational Therapist | 431 N Walnut Ave, Ketchum, ID 83340 | 2020-10-29 |
| 1841826252 | Pilar Settlemier Tumolo | Counselor | 220 River Street East, Ketchum, ID 83340 | 2020-03-17 |
| 1598390643 | Alyson Holmes Witmer | Counselor | 220 2nd Ave, Ste 201, Ketchum, ID 83340 | 2020-03-10 |
| 1952864506 | Mollie Parker Szybala | Naturopath | 128 Saddle Rd, Suite 103-c, Ketchum, ID 83340 | 2019-04-10 |
| 1740789353 | Courtney Loving | Counselor | 208 N. Spruce, Ketchum, ID 83340 | 2018-02-09 |
| 1164876785 | Rebecca Grace | Psychologist | 200 River St East, Ketchum, ID 83340 | 2016-04-20 |
| 1306209556 | Garrett Coman | Dermatology | St. Luke's Dermatology, 191 5th Street West, Ketchum, ID 83340 | 2016-04-04 |
| 1265895775 | Innerhealth Md PC | Acupuncturist | 180 West 1st Street, Suite 206, Ketchum, ID 83340 | 2016-04-01 |
| 1487023503 | Tomomi Ikawa | Chiropractor | 131 4th St. E., Suite 310, Ketchum, ID 83340 | 2015-09-18 |
| 1790195766 | Maria Morris | Acupuncturist | 220 South 2nd Ave #101, Ketchum, ID 83340 | 2014-04-30 |
| Find all providers in zip 83340 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306055850 | Nanette Cornish Ford | Physician Assistant | 180 East Avenue, Ketchum, ID 83340 | 2007-05-22 |
| 1942638846 | Ashley Brown | Physician Assistant | 431 Walnut Ave N, Ketchum, ID 83340 | 2013-10-31 |
| 1790030518 | Jill K. Zelaya | Physician Assistant | 100 Hospital Dr., Ketchum, ID 83340 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695792 | Chelsea Dylan Tennent | Physician Assistant | 1666 E Gentlewind St, Boise, ID 83706-5914 | 2020-10-05 |
| 1922615848 | Allison Cluff | Physician Assistant | 1320 Bennett Ave, Burley, ID 83318-2665 | 2020-09-24 |
| 1245846187 | Adam Baker | Physician Assistant | 271 Jefferson St, Blackfoot, ID 83221-1818 | 2020-09-16 |
| 1265045199 | Julia Claire Brodie | Physician Assistant | 2352 N Apple Ln, Pocatello, ID 83204-7231 | 2020-08-29 |
| 1326651035 | Jenna Marie Castillo | Physician Assistant | 150 Taft Ave, Pocatello, ID 83201-5140 | 2020-08-24 |
| 1174148696 | Colton Jason Randall | Physician Assistant | 3885 Orchard Cir, Ammon, ID 83406-4656 | 2020-06-10 |
| 1871114553 | Samantha Tess Goodrich | Physician Assistant | 721 E Lenz St, Boise, ID 83712-7846 | 2020-05-04 |
| 1174164305 | Tessie Mari Mcinnally | Physician Assistant | 3015 E Magic View Dr # 115, Meridian, ID 83642-3743 | 2019-09-29 |
| 1013562305 | Brianna Suzanne Berg | Physician Assistant | 12535 N Fawn Ct, Hayden, ID 83835-8827 | 2019-08-05 |
| 1003376559 | Kodie Thomas | Physician Assistant | 2086 Picket Ln, Emmett, ID 83617-9104 | 2019-03-21 |
| Find all providers with the same taxonomy | ||||
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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.