DR. GREGORY DEAN DIETRICH (NPI# 1306831698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306831698 |
| Entity Type | Individual |
| Full Name | DR. GREGORY DEAN DIETRICH |
| Credential | MD |
| Practice Address |
320 Warner Drive Lewiston ID 83501 |
| Practice Telephone | 2087433523 |
| Practice Fax Number | 2087468741 |
| Mailing Telephone | 2087433523 |
| Mailing Fax Number | 2087468741 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2016-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
M7482 | ID | Allopathic & Osteopathic Physicians |
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
00034506 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE | 000010004322 | 01 |
| ID | 805208800 | 05 | |
| WA | 8204851 | 05 | |
| ID | BCI | 74823 | 01 |
| Street Address |
320 WARNER DRIVE |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437222528 | Jeremy B Ostermiller | Physician Assistant | 320 Warner Drive, Lewiston, ID 83501 | 2006-11-16 |
| 1952474041 | Leroy Neal Keene | Physician Assistant | 320 Warner Drive, Lewiston, ID 83501 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083998827 | Boise Spine Surgery P.a. | Orthopaedic Surgery | 8756 W. Emerald Street, Suite 176, Boise, ID 83704-4834 | 2011-09-28 |
| 1316029176 | Lynn J Stromberg | Orthopaedic Surgery | 2355 Coronado, Idaho Falls, ID 83404 | 2006-10-20 |
| 1396827150 | Mark A Weight | Orthopaedic Surgery | 2355 Coronado St, Idaho Falls, ID 83404-7407 | 2006-10-20 |
| 1699710541 | Joseph M Verska | Orthopaedic Surgery | 8756 W. Emerald St., Suite 176, Boise, ID 83704-4834 | 2006-06-17 |
| 1124060983 | Verst Spine & Orthopedic Care,pllc | Orthopaedic Surgery | 15 West Galena St, Hailey, ID 83333 | 2006-06-12 |
| 1104489376 | Spine Cin of Boise, LLC | Orthopaedic Surgery | 800 W Main St Ste 1460-10, Boise, ID 83702-5945 | 2019-04-15 |
| 1871850727 | Daniel John Blizzard | Orthopaedic Surgery | 1641 E Polston Ave Ste 101, Post Falls, ID 83854-7852 | 2012-04-17 |
| 1023029840 | Howard A King | Orthopaedic Surgery | 600 N Robbins Rd, Ste 100, Boise, ID 83702-4566 | 2006-08-10 |
| 1659380269 | Spine Institute of Idaho P A | Orthopaedic Surgery | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2006-08-05 |
| 1962447169 | Samuel Steven Jorgenson | Orthopaedic Surgery | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2006-06-19 |
| Find all providers with the same taxonomy | ||||
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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.