DR. MICHAEL R. DJERNES (NPI# 1346230356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346230356 |
Entity Type | Individual |
Full Name | DR. MICHAEL R. DJERNES |
Credential | M.D. |
Practice Address |
215 E Hawaii Ave Nampa ID 83686-6011 |
Practice Telephone | 2084633197 |
Practice Fax Number | 2084633044 |
Mailing Telephone | 2084633244 |
Mailing Fax Number | 2084633388 |
Enumeration Date | 2005-10-21 |
Last Update Date | 2020-08-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
M5756 | ID | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | BLUE CROSS | 57562 | 01 |
ID | BLUE CROSS | 45153 | 01 |
ID | BLUE SHIELD | 000010001980 | 01 |
ID | 002363800 | 05 | |
ID | BLUE SHIELD | 000010034804 | 01 |
ID | BLUE CROSS | 39594 | 01 |
ID | RAILROAD MEDICARE | 130007001 | 01 |
Street Address |
215 E HAWAII AVE |
City | NAMPA |
State | ID |
Zip Code | 83686-6011 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396740668 | Peter Stevan Jerome | Internal Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-06-14 |
1174145809 | Carolyn Knackstedt | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
1609498336 | Houston Reynolds | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
1427670157 | Ali Sup | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
1710509443 | Rory Hawker | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
1689295180 | Patricia J Funkhouser | Nurse Practitioner | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-06 |
1275169252 | Ashley Whitlow | Nurse Practitioner | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-03-21 |
1669002721 | Nicole Webb | Physician Assistant | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-01-16 |
1548824964 | Catherine Heil | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2019-05-01 |
1174187587 | Mark Dahle | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2019-05-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
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Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386692333 | Lawrence E Green | Psychiatry & Neurology | 16060 Idaho Center Blvd, Nampa, ID 83687 | 2006-05-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508286188 | Nina Sienna Bozinov | Psychiatry & Neurology | 700 W Ironwood Dr Ste 158, Coeur D Alene, ID 83814-4404 | 2014-04-22 |
1922449453 | Sarita Said Said | Psychiatry & Neurology | 2400 W A St, Moscow, ID 83843-4902 | 2013-07-12 |
1386903359 | Daniel B Simmons | Psychiatry & Neurology | 1072 N Liberty St Ste 303, Boise, ID 83704 | 2012-05-11 |
1053678342 | Daniel Clark Abenroth | Psychiatry & Neurology | 9th Floor -- Neurosciences, 190 E Bannock St., Boise, ID 83712-8905 | 2012-04-12 |
1427294545 | Thomas E Henson | Psychiatry & Neurology | 3183 S Temperance Way, Boise, ID 83706-5703 | 2008-12-18 |
1235381948 | Karin Lindholm, D.o. | Psychiatry & Neurology | 901 N Curtis Rd Ste 403, Boise, ID 83706-1342 | 2008-10-14 |
1548452683 | Sergei V Kashirny | Psychiatry & Neurology | 125 E Idaho St Ste 300, Neurology, Boise, ID 83712-6256 | 2007-08-13 |
1316090426 | Affiliated Neurologists Pllc | Psychiatry & Neurology | 338 6th St, Suite 102, Lewiston, ID 83501-2419 | 2007-01-19 |
1578667739 | Mary Elizabeth Gerard | Psychiatry & Neurology | 333 N 18th Ave Ste B4, Pocatello, ID 83201 | 2006-09-11 |
1437252723 | Eastern Idaho Neurological Associates Pa | Psychiatry & Neurology | 2353 Coronado Drive, Idaho Falls, ID 83404 | 2006-09-05 |
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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.