DEVIN R PUGMIRE


Address: 300 S 23rd St, Boise, ID 83702-9100
Phone: 2083443512

DEVIN R PUGMIRE (NPI# 1235613688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235613688
Entity Type Individual
Full Name DEVIN R PUGMIRE
Credential PSS
Practice Address 300 S 23rd St
Boise
ID 83702-9100
Mailing Address Po Box 9
Nampa
ID 83653-0009
Practice Telephone 2083443512
Practice Fax Number 2083444898
Mailing Telephone 2084617149
Mailing Fax Number 2084673391
Enumeration Date 2018-09-21
Last Update Date 2018-09-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 300 S 23RD ST
City BOISE
State ID
Zip Code 83702-9100

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437132479 Vivek Kantayya Family Medicine 300 S 23rd St, Boise, ID 83702-9100 2005-11-23
1639716236 Wayne Nubile Counselor 300 S 23rd St, Boise, ID 83702-9100 2019-12-03
1487299129 Dusty L Orr Social Worker 300 S 23rd St, Boise, ID 83702-9100 2019-11-15
1902459266 Melissa Adele Wren Perry Nurse Practitioner 300 S 23rd St, Boise, ID 83702-9100 2019-07-16
1386128726 Samantha Joseph Social Worker 300 S 23rd St, Boise, ID 83702-9100 2018-09-21
1023599586 Joseph P Digrazia Counselor 300 S 23rd St, Boise, ID 83702-9100 2018-08-23
1790263234 Stephanie M. Meeks Social Worker 300 S 23rd St, Boise, ID 83702-9100 2018-08-06
1205322310 Brian Lee Collins Social Worker 300 S 23rd St, Boise, ID 83702-9100 2018-07-02
1972982437 Matthew Todd Posluszny Social Worker 300 S 23rd St, Boise, ID 83702-9100 2015-05-29
1255719092 Matthew Caleb Weaver Peer Specialist 300 S 23rd St, Boise, ID 83702-9100 2015-05-13
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NPI Name Taxonomy Address Enumeration
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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
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1578912051 Marnae Walker Counselor 509 S. 14th St, Suite 2, Boise, ID 83702 2016-06-06
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Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

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1790307890 Jx2 LLC Peer Specialist 8950 W Emerald St Ste 178, Boise, ID 83704-8296 2020-05-12
1043860919 Stephanie Coulter Peer Specialist 2200 W Fairview Ave, Boise, ID 83702-6808 2019-09-12
1538721014 All Seasons Mental Health Peer Specialist 6933 W Emerald St, Boise, ID 83704-8616 2019-07-03
1881157949 Lacey Megorden Peer Specialist 4222 W Emerald St, Boise, ID 83706-2037 2019-04-07
1255793659 Michele Hickman Peer Specialist 1720 N Westgate Dr, Boise, ID 83704-7164 2016-03-24
1255719092 Matthew Caleb Weaver Peer Specialist 300 S 23rd St, Boise, ID 83702-9100 2015-05-13

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1639779523 Tracie Lyn Hansen Peer Specialist 560 Fairway Dr, Pocatello, ID 83201-2012 2020-10-29
1609426923 Amie Hughes Peer Specialist 4737 S Afton Pl Ste A, Chubbuck, ID 83202-2317 2019-09-18
1184113482 Kolleen Marie Wynn-gallipeau Peer Specialist 444 Hospital Way Ste 447, Pocatello, ID 83201-2744 2018-05-02
1063034437 Inroads, Inc Peer Specialist 3288 E Pine Ave, Meridian, ID 83642-5922 2020-05-08
1356962112 Aaa American Healthcare LLC Peer Specialist 1301 E 17th St, Idaho Falls, ID 83404-6273 2020-05-04
1346878691 Aspen Ministries Syringa Wellness Peer Specialist 1609 S Kimball Ave Ste 200, Caldwell, ID 83605-5196 2020-03-31
1962033399 Lookout Behavioral Health LLC Peer Specialist 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 2020-02-04
1356981419 Lake City Counseling Center Peer Specialist 9705 N Shaw St, Hayden, ID 83835-9716 2020-01-07
1700425600 Center Counseling, LLC Peer Specialist 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 2019-12-26
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Competitor

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City BOISE
Zip Code 83702

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Dataset Information

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.

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