IDAHO STATE UNIVERSITY (NPI# 1235737347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235737347 |
| Entity Type | Organization |
| Organization Name | IDAHO STATE UNIVERSITY |
| Practice Address |
1311 E Central Dr Meridian ID 83642-7991 |
| Practice Telephone | 2083731719 |
| Mailing Telephone | 2083731719 |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | CYNTHIA LEE ROCK (CLINICS DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 2083731743 |
| Is Organization Subpart | Y |
| Parent Organization Name | IDAHO STATE UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ISU Meridian Counseling Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1801292115 | Idaho State University | Family Medicine | 921 S 8th Ave Stop 8173, Sports and Orthopaedic Center, Pocatello, ID 83209-8173 | 2014-11-13 |
| 1730351081 | Idaho State University | Pharmacy | 990 South 8th, Pocatello, ID 83209 | 2008-03-27 |
| 1972720936 | Idaho State University | Dental Hygienist | 999 Martin Luther King Jr. Way, Pocatello, ID 83209-8048 | 2007-04-19 |
| 1356491187 | Idaho State University | Physical Therapist | 1400 E. Terry, Garrison Bldg. 63 #202, Pocatello, ID 83209-8045 | 2007-01-12 |
| 1578508081 | Idaho State University | Audiologist | 650 Memorial Drive, # 68, Pocatello, ID 83209-0001 | 2006-06-18 |
| 1295105567 | Idaho State University | Clinical Medical Laboratory | 970 S 5th Ave, Stop 8288, Pocatello, ID 83209-0001 | 2015-09-30 |
| 1114285996 | Idaho State University | Local Education Agency (LEA) | 921 S 8th Ave, Mail Stop 8219, Pocatello, ID 83209-8219 | 2012-04-30 |
| 1912110164 | Idaho State University | Dentist | 2033 E Summersweet Dr, Boise, ID 83716-6695 | 2007-05-07 |
| 1851516256 | Idaho State University | Dentist | 465 Memorial Dr., Pocatello, ID 83209-8088 | 2007-04-13 |
| Street Address |
1311 E CENTRAL DR |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-7991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356481691 | Jennifer L Adams | Pharmacist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2007-02-07 |
| 1558979948 | Kristina Montemale | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2020-07-21 |
| 1821606948 | Bryan Schofield | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2020-07-14 |
| 1780201889 | Stephen Edward Leeb | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2020-07-06 |
| 1841852563 | Jennafer Kedish | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2019-07-02 |
| 1518528108 | Allan Baker | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2019-06-24 |
| 1285295923 | Sean Elliot Ziegler | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2019-06-24 |
| 1750876967 | Kevin Zachary Sunitsch | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2018-06-29 |
| 1942795968 | Jesse Schwartz | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2018-06-22 |
| 1275055162 | Paul Tyler Lytle | Dentist | 1311 E Central Dr, Meridian, ID 83642-7991 | 2017-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003432626 | Positive Innergy Counseling Services, LLC | Clinic/Center | 6562 King Rd, Meridian, MS 39305-8364 | 2020-06-19 |
| 1073148623 | Begin Within Counseling, LLC | Clinic/Center | 943 W Overland Rd Ste 111, Meridian, ID 83642-6541 | 2020-03-04 |
| 1174155741 | Noble Intent | Clinic/Center | 1406 N Main St Ste 204, Meridian, ID 83642-1746 | 2020-02-11 |
| 1194362517 | Advanced Counseling LLC | Clinic/Center | 39 W Pine Ave, Meridian, ID 83642-2281 | 2019-12-04 |
| 1316293038 | Helping Hands Outreach Incorporated | Clinic/Center | 4296 E Stonebridge Dr, Meridian, ID 83642 | 2012-07-31 |
| 1508170424 | Friendship Center-community Outreach Services | Clinic/Center | 5701 North Hill Street, Meridian, MS 39307-2903 | 2010-08-03 |
| 1346573532 | Midvalley Healthcare Pllc | Clinic/Center | 2321 E Gala St Ste 3, Meridian, ID 83642-7692 | 2009-09-07 |
| 1346489457 | Children's Clinic of Meridian | Clinic/Center | 1430 Hwy 19 N, Meridian, MS 39307-5378 | 2009-02-12 |
| 1497380794 | Finesse Mental Health Wellness and Counseling Services | Clinic/Center | 1807 39th Pl, Meridian, MS 39307-5562 | 2020-03-06 |
| 1518507722 | Ada West Counseling LLC | Clinic/Center | 925 N Main St, Meridian, ID 83642-2301 | 2020-01-15 |
| Find all providers in MERIDIAN | ||||
Please comment or provide details below to improve the information on IDAHO STATE UNIVERSITY.
| 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.