MOUNTAIN STATES NEONATOLOGY, INC. (NPI# 1205850823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205850823 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES NEONATOLOGY, INC. |
| Practice Address |
1055 N Curtis Rd Boise ID 83706-1309 |
| Mailing Address |
4722 N 24th St Ste. 150 Phoenix AZ 85016-4800 |
| Practice Telephone | 2083677610 |
| Practice Fax Number | 2083677616 |
| Mailing Telephone | 6022564628 |
| Mailing Fax Number | 8558514319 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-04-03 |
| Authorized Official Name | ERIC KURZWEIL (DIRECTOR) |
| Authorized Official Telephone | 6022564628 |
| Authorized Official Credential | MD, M.B.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806075900 | 05 |
| Street Address |
1055 N CURTIS RD |
| City | BOISE |
| State | ID |
| Zip Code | 83706-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235122284 | Christopher Jay Sjoberg | Nurse Practitioner | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2005-08-24 |
| 1689287021 | Brian Jones | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-08-25 |
| 1346868759 | Rhianna Wallace | Occupational Therapist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-12 |
| 1447877824 | Chelsea Zipse | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-01 |
| 1770105181 | Eric Munoz Quiroz | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-05-08 |
| 1477197036 | Megan Lenkersdorfer | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-11-06 |
| 1104477967 | Paul David Cochran | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-24 |
| 1649820259 | Monica Marie Mclain | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-16 |
| 1619526613 | Calan Szmyd | Genetic Counselor, MS | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-11 |
| 1922650613 | Allison A. Martinez | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
| 1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| Find all providers in zip 83706 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144269747 | Stewart Lawrence | Pediatrics | 6030 W Emerald St, Boise, ID 83704-8855 | 2006-06-06 |
| 1780870360 | Nathan L Thornton | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2007-09-18 |
| 1558495796 | James W Vanlooy | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2007-03-16 |
| 1598828378 | Erik N Meyers | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-12-19 |
| 1629000716 | Scott A Snyder | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-07-07 |
| 1265461198 | Cynthia Edstrom | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-07-02 |
| 1922037852 | Charlene A Crichton | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-07-02 |
| 1366488058 | Nick E Harper | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-06-21 |
| 1457395477 | Ronald W Coen | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-06-16 |
| 1629016043 | Declan P O'riordan | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-06-04 |
| Find all providers in BOISE | ||||
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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.