COMMUNITY CARE WEST SIDE LLC (NPI# 1295009785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295009785 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE WEST SIDE LLC |
| Practice Address |
765 S Utah Ave Idaho Falls ID 83402-5093 |
| Practice Telephone | 2085252600 |
| Practice Fax Number | 2085252611 |
| Mailing Telephone | 2085252600 |
| Mailing Fax Number | 2085252611 |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2017-04-05 |
| Authorized Official Name | HEATHER MCVEY (OFFICE MANAGER) |
| Authorized Official Telephone | 2085252600 |
| Authorized Official Credential | CPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
765 S UTAH AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-5093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306865464 | Derek R Campbell | Family Medicine | 765 S Utah Ave, Idaho Falls, ID 83402-5093 | 2006-07-19 |
| 1164584074 | Caren J Smith | Physician Assistant | 765 S Utah Ave, Idaho Falls, ID 83402-5093 | 2006-12-15 |
| 1801963459 | James L Blaine | Physician Assistant | 765 S Utah Ave, Idaho Falls, ID 83402-5093 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740663806 | Rindfleisch Family Practice Pllc | Family Medicine | 4954 E Powerhouse Dr, Idaho Falls, ID 83406-5064 | 2015-07-07 |
| 1013204445 | Machen Family Medicine, PC | Family Medicine | 1995 E 17th St Ste A, Idaho Falls, ID 83404-6493 | 2011-07-06 |
| 1942521109 | Luke N/a Haws | Family Medicine | 2985 Cortez Ave Ste 200, Idaho Falls, ID 83404-7554 | 2010-06-22 |
| 1689993271 | David Lyle Hill | Family Medicine | 3242 S Woodruff, Idaho Falls, ID 83404-7531 | 2010-05-23 |
| 1912120544 | James William Brook | Family Medicine | 905 Austin Ave, Idaho Falls, ID 83404 | 2007-04-11 |
| 1437294345 | Oliver Daniel Smith | Family Medicine | 3669 Ellendale Circle, Idaho Falls, ID 83406 | 2007-02-20 |
| 1023151156 | Physician Skin Care | Family Medicine | 730 S Woodruff Ave, Idaho Falls, ID 83401-5285 | 2007-02-15 |
| 1598837031 | Anne L Broadway | Family Medicine | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2006-11-13 |
| 1235217506 | Reed Ivol Ward | Family Medicine | 3425 Potomac Way, Idaho Falls, ID 83404-4970 | 2006-11-02 |
| 1770688426 | Tony Craig Roisum | Family Medicine | 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404-8332 | 2006-09-14 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
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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.