DR. DAVID REED CONDIE (NPI# 1356329783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356329783 |
| Entity Type | Individual |
| Full Name | DR. DAVID REED CONDIE |
| Credential | M.D. |
| Practice Address |
98 Poplar St Blackfoot ID 83221-1758 |
| Mailing Address |
9592 N Deerfield Ln Cedar Hills UT 84062-7707 |
| Practice Telephone | 2087854100 |
| Practice Fax Number | 2102923760 |
| Mailing Telephone | 2102164742 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2015-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
M-12609 | ID | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
35-067004 | OH | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 036.127977 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
98 POPLAR ST |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-1758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609871474 | Wade H Flowers Jr. | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2005-06-16 |
| 1629685177 | Lucus Craig Webb Christoffersen | Registered Nurse | 98 Poplar St, Blackfoot, ID 83221-1799 | 2020-09-29 |
| 1770111924 | Kywnynn Madsen | Dietitian, Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2020-03-31 |
| 1235795915 | Megan Lewis | Advanced Practice Midwife | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-05-17 |
| 1083177935 | Jason Lee Harmon | Student in an Organized Health Care Education/Training Program | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-04-08 |
| 1851870091 | Jennifer L Wistisen | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1799 | 2018-08-08 |
| 1114405396 | Ryan Blair Killpack | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-31 |
| 1023504651 | Amanda Wray | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-06 |
| 1699268276 | Zachary D Morrow | Nurse Anesthetist, Certified Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-06-08 |
| 1184115107 | Megan Nicole Broyles | Pharmacist | 98 Poplar St, Blackfoot, ID 83221 | 2018-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386685535 | David Shelley | Radiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508224379 | Teton Vascular Institute of Pocatello A Series of Teton Group | Radiology | 444 Hospital Way Bldg 100, Ste 111, Pocatello, ID 83201-2745 | 2016-02-08 |
| 1851871172 | Russell L Evans | Radiology | 320 Warner Dr, Lewiston, ID 83501-4441 | 2018-08-16 |
| 1083842033 | Andrew Albert Peterson | Radiology | 190 E Bannock St, Boise, ID 83712-6241 | 2009-06-29 |
| 1154584712 | Gem State Radiology LLP | Radiology | 161 E Mallard Dr, Suite 130, Boise, ID 83706-3974 | 2008-07-03 |
| 1760682066 | Paul David Sonntag | Radiology | 190 E Bannock, Boise, ID 83712 | 2007-07-24 |
| 1629007844 | Idaho Vascular Institute Pllc | Radiology | 4400 E Flamingo Ave, Nampa, ID 83687-9203 | 2006-07-01 |
| 1316913254 | John H Whiting Jr. | Radiology | 444 Hospital Way, Suite 701, Pocatello, ID 83201-2701 | 2006-02-28 |
| 1023096955 | John W. Ho | Radiology | 415 6th St, Lewiston, ID 83501-2431 | 2005-12-30 |
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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.