DR. JONATHAN CRAIG STEVENS (NPI# 1366495178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366495178 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN CRAIG STEVENS |
| Other Name | DR. J CRAIG STEVENS |
| Credential | MD |
| Practice Address |
105 Vermeer Dr Unit 1 Ponderay ID 83852-9802 |
| Mailing Address |
Po Box 353 Clark Fork ID 83811 |
| Practice Telephone | 2082661677 |
| Practice Fax Number | 2082660440 |
| Mailing Telephone | (208) 266-1677 |
| Mailing Fax Number | 2082660440 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | M7507 | ID | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | M7507 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805192200 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 750 N Syringa St Ste 203, Post Falls, ID 838545275 | 2082661677 | 2087655654 |
| 60319 Highway 200, Clark Fork, ID 83811 | 2082661677 | 2082660440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780101006 | Jonathan Stevens | Behavioral Analyst | 15252 Seneca Rd Spc 309, Victorville, CA 92392-2278 | 2017-08-28 |
| 1871013847 | Jonathan Leonard Stevens | Social Worker | 426 Century Ln Ste 100, Holland, MI 49423-2200 | 2017-06-21 |
| 1588758163 | Jonathan D Stevens | Chiropractor | 520 11th Ave, Safford, AZ 85546 | 2006-10-03 |
| 1396793493 | Jonathan R Stevens | Psychiatry & Neurology | 12301 Main Street, The Menninger Clinic, Houston, TX 77035 | 2006-05-04 |
| 1619413358 | Jonathan Stevens | Physical Therapist | 2241 Peggy Ln, Suite C, Garland, TX 75042-5732 | 2017-01-18 |
| 1245574607 | Jonathan David Stevens | Chiropractor | 4012 Park Rd, Suite 103, Charlotte, NC 28209-2377 | 2012-11-23 |
| 1063714608 | Jonathan M Stevens | Emergency Medicine | 450 W 10th Ave, Columbus, OH 43210-1240 | 2010-12-02 |
| 1407067028 | Jonathan A. Stevens | Optometrist | 601 Sunrise Hwy, Lynbrook, NY 11563-3246 | 2007-05-25 |
| 1184762155 | Jonathan D Stevens | Psychologist | 430 E Lauridsen Blvd, Port Angeles, WA 98362-7978 | 2007-02-02 |
| Street Address |
105 VERMEER DR UNIT 1 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852-9802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750692562 | James Aroet Whitaker | Neuromusculoskeletal Medicine & OMM | 9510 W Fairview Ave, Boise, ID 83704-8103 | 2010-06-25 |
| 1164507166 | John A Sturges | Neuromusculoskeletal Medicine & OMM | 2170 W Ironwood Center Dr Ste A, Coeur D Alene, ID 83814-2606 | 2006-10-26 |
| 1134219330 | North Idaho Neurosurgery and Spine, Pllc | Neuromusculoskeletal Medicine & OMM | 1641 E. Polston Ave., Post Falls, ID 83854 | 2006-10-16 |
| 1073529202 | Christopher C Peine | Neuromusculoskeletal Medicine & OMM | 507 S Fitness Pl, Ste 110, Eagle, ID 83616-6552 | 2006-07-31 |
| 1356759781 | Idaho Joint and Spine PC | Neuromusculoskeletal Medicine & OMM | 9510 W Fairview Ave, Boise, ID 83704-8103 | 2014-07-29 |
| 1902139066 | Laura Thalia Reis | Neuromusculoskeletal Medicine & OMM | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2009-09-08 |
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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.