CHRISTIE ANN CEBALLOS (NPI# 1356537989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356537989 |
| Entity Type | Individual |
| Full Name | CHRISTIE ANN CEBALLOS |
| Credential | PA |
| Practice Address |
11959 E Whitetail Dr Athol ID 83801-8418 |
| Practice Telephone | 2099855247 |
| Mailing Telephone | 2099855247 |
| Mailing Fax Number | 2099855247 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2019-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60546976 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA19348 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1356537989 | 05 | |
| WA | MEDICARE | G8941441 | 01 |
| Street Address |
11959 E WHITETAIL DR |
| City | ATHOL |
| State | ID |
| Zip Code | 83801-8418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366510752 | Christopher Ray Sundquist | Physician Assistant | 6101 W Hwy 54, Suite A, Athol, ID 83801 | 2006-12-01 |
| 1053496869 | Connie Jean Stone | Massage Therapist | 6115 E Hwy 54, Athol, ID 83801 | 2006-10-27 |
| 1659568871 | Carrie Valentine Blake | Midwife | 3155 Gwenn Ct, Athol, ID 83801-4909 | 2007-10-02 |
| 1952673204 | Donald K Merkeley | Pathology | 16301 E Bunco Rd, Athol, ID 83801-5048 | 2012-02-02 |
| 1366982316 | Davina Gelardi | Massage Therapist | 6101 E Highway 54, Athol, ID 83801-6085 | 2017-02-24 |
| 1578956637 | Country Clinical Massage | Massage Therapist | 6101 E Highway 54 Ste A, Athol, ID 83801-6085 | 2015-03-13 |
| 1629513940 | Kelly Sorensen | Lactation Consultant, Non-RN | 23582 Rapalla Ct, Athol, ID 83801-7002 | 2016-12-21 |
| 1720390347 | Charla-jo Olorenshaw Spradlin | Physical Therapist | 26453 N Old Highway 95, Athol, ID 83801-7076 | 2010-07-12 |
| 1174783724 | Tamara Marie Barnhart | Chiropractor | 6101 E Highway 54, Unit A, Athol, ID 83801-8255 | 2008-06-16 |
| 1932392933 | Timberlake Family Medicine | Clinic/Center | 6101 E Highway 54 Ste A, Athol, ID 83801-8255 | 2007-08-22 |
| Find all providers in zip 83801 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790158459 | Southeast First Assistant LLC | Physician Assistant | 12473 E Nunn Rd, Athol, ID 83801-9311 | 2015-11-03 |
| 1962979385 | Marina Konomi | Physician Assistant | 81 Reservoir Dr, Athol, MA 01331-4901 | 2018-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695792 | Chelsea Dylan Tennent | Physician Assistant | 1666 E Gentlewind St, Boise, ID 83706-5914 | 2020-10-05 |
| 1922615848 | Allison Cluff | Physician Assistant | 1320 Bennett Ave, Burley, ID 83318-2665 | 2020-09-24 |
| 1245846187 | Adam Baker | Physician Assistant | 271 Jefferson St, Blackfoot, ID 83221-1818 | 2020-09-16 |
| 1265045199 | Julia Claire Brodie | Physician Assistant | 2352 N Apple Ln, Pocatello, ID 83204-7231 | 2020-08-29 |
| 1326651035 | Jenna Marie Castillo | Physician Assistant | 150 Taft Ave, Pocatello, ID 83201-5140 | 2020-08-24 |
| 1174148696 | Colton Jason Randall | Physician Assistant | 3885 Orchard Cir, Ammon, ID 83406-4656 | 2020-06-10 |
| 1871114553 | Samantha Tess Goodrich | Physician Assistant | 721 E Lenz St, Boise, ID 83712-7846 | 2020-05-04 |
| 1174164305 | Tessie Mari Mcinnally | Physician Assistant | 3015 E Magic View Dr # 115, Meridian, ID 83642-3743 | 2019-09-29 |
| 1013562305 | Brianna Suzanne Berg | Physician Assistant | 12535 N Fawn Ct, Hayden, ID 83835-8827 | 2019-08-05 |
| 1003376559 | Kodie Thomas | Physician Assistant | 2086 Picket Ln, Emmett, ID 83617-9104 | 2019-03-21 |
| 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.