GLENN C BOTHWELL (NPI# 1235183054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235183054 |
| Entity Type | Individual |
| Full Name | GLENN C BOTHWELL |
| Credential | MD |
| Practice Address |
703 S Americana Blvd Boise ID 83702-5099 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2087067500 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-02-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
M3165 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
703 S AMERICANA BLVD |
| City | BOISE |
| State | ID |
| Zip Code | 83702-5099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225020993 | April D Southwick | Nurse Practitioner | 703 S Americana Blvd, Ste 130, Boise, ID 83702-5099 | 2005-08-18 |
| 1003246778 | Melissa Pirtle | Physical Therapist | 703 S Americana Blvd, Suite 130, Boise, ID 83702-5099 | 2013-11-18 |
| 1770790313 | Cody D Heiner | Preventive Medicine | 703 S Americana Blvd, Boise, ID 83702-5099 | 2007-05-16 |
| 1104044247 | David M Landis | Physician Assistant | 703 S Americana Blvd, Ste 130, Boise, ID 83702-5099 | 2007-04-23 |
| 1205910551 | Nicolas J. Allen | Physician Assistant | 703 S Americana Blvd, Ste 120, Boise, ID 83702-5099 | 2006-10-24 |
| 1215948807 | Ronald M Kristensen | Orthopaedic Surgery | 703 S Americana Blvd, Suite 120, Boise, ID 83702-5099 | 2006-08-10 |
| 1306856471 | Robert N Walker | Orthopaedic Surgery | 703 S Americana Blvd, Ste 120, Boise, ID 83702-5099 | 2006-08-09 |
| 1659388783 | Benjamin T Kerns | Physician Assistant | 703 S Americana Blvd, Suite 120, Boise, ID 83702-5099 | 2006-08-02 |
| 1043226715 | Darby Webb | Orthopaedic Surgery | 703 S Americana Blvd, Suite 120, Boise, ID 83702-5099 | 2006-08-01 |
| 1801801576 | Christopher T Lawler | Orthopaedic Surgery | 703 S Americana Blvd, Suite 120, Boise, ID 83702-5099 | 2006-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538339833 | Lowell A Schuknecht Jr. | Preventive Medicine | 5352 Hill Rd, Boise, ID 83703-2944 | 2008-03-03 |
| 1497211148 | Treasure Valley Occupational Medicine | Preventive Medicine | 8800 W Emerald St Ste 196, Boise, ID 83704-8205 | 2019-02-19 |
| 1144673021 | Saint Alphonsus Regional Medical Center | Preventive Medicine | 6533 W Emerald St, Boise, ID 83704-8737 | 2016-07-15 |
| 1295907210 | Margaret Kay Cook-shimanek | Preventive Medicine | 6533 Emerald Street, Boise, ID 83704-8737 | 2008-03-31 |
| 1770790313 | Cody D Heiner | Preventive Medicine | 703 S Americana Blvd, Boise, ID 83702-5099 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740679711 | Paul Creighton | Preventive Medicine | 5038 E River Pl, Post Falls, ID 83854-6891 | 2015-01-14 |
| 1609014117 | John W. Jones | Preventive Medicine | 1017 E Young, Hope Wellness Center, Pocatello, ID 83201-4406 | 2009-01-22 |
| 1619173754 | William Francis Belk | Preventive Medicine | 1955 Fremont St, Inl Omp, Idaho Falls, ID 83415-0001 | 2007-06-25 |
| 1073718391 | Valley Vista Therapy Services | Preventive Medicine | 820 Elm St, St Maries, ID 83861-2119 | 2007-06-18 |
| 1629107131 | Howard W Shoemaker | Preventive Medicine | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2007-03-02 |
| 1497825285 | Stewart Ryan Curtis | Preventive Medicine | 2920 Cortez Ave, Idaho Falls, ID 83404-7554 | 2006-11-08 |
| 1619904638 | Douglas L Stagg | Preventive Medicine | 775 Pole Line Rd W, Suite 101, Twin Falls, ID 83301-5814 | 2006-06-26 |
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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.