IDAHO FALLS PEDIATRICS (NPI# 1366560971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366560971 |
| Entity Type | Organization |
| Organization Name | IDAHO FALLS PEDIATRICS |
| Practice Address |
2375 Coronado St Idaho Falls ID 83404-7407 |
| Practice Telephone | 2085224600 |
| Practice Fax Number | 2085527521 |
| Mailing Telephone | 2085224600 |
| Mailing Fax Number | 2085527521 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RON WADE PORTER (OWNER) |
| Authorized Official Telephone | 2085224600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
M7271 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
2375 CORONADO ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770577728 | Ron Wade Porter | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2005-09-06 |
| 1235780990 | Katie Jo Leask | Dietitian, Registered | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2019-09-24 |
| 1255621793 | Mitchael Conrad Steorts | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2011-04-18 |
| 1477608099 | Darin Leslie | Physician Assistant | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2007-01-24 |
| 1043204746 | Scott Alan Smith | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2005-09-08 |
| 1760476469 | Joseph Reed Moore | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2005-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255621793 | Mitchael Conrad Steorts | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2011-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285797241 | Roger W. Boe | Pediatrics | 405 W Whitman St, Pocatello, ID 83204-3317 | 2006-12-19 |
| 1184738700 | Christian Carter Yost | Pediatrics | 950 Hospital Way Ste A, Pocatello, ID 83201-2762 | 2006-08-19 |
| 1437151446 | Matthew Ayers Murdoch | Pediatrics | 1151 Hospital Way, Building F, Pocatello, ID 83201-5091 | 2005-08-10 |
| 1053675629 | Kootenai Kids Pediatrics Pllc | Pediatrics | 761 N Thornton St, Ste A, Post Falls, ID 83854-6105 | 2012-06-28 |
| 1912223959 | Cindy Elizabeth Parsons | Pediatrics | 1151 Hospital Way, Bldg F, Pocatello, ID 83201 | 2010-04-15 |
| 1861681611 | Steven Alan Smith | Pediatrics | 6348 W Emerald St, Boise, ID 83704-8732 | 2007-10-17 |
| 1003975087 | Lakeside Pediatric & Adolescent Medicine, Pllc | Pediatrics | 980 W Ironwood Dr, Ste 302, Coeur D'alene, ID 83814-2601 | 2006-12-06 |
| 1962516583 | Gentry C Yost | Pediatrics | 1151 Hospital Way, Building F, Pocatello, ID 83201-5091 | 2006-08-19 |
| 1114954179 | Sandpoint Pediatrics LLP | Pediatrics | 420 N 2nd Ave, 100, Sandpoint, ID 83864-1552 | 2006-06-27 |
| 1548201932 | Barton Adrian | Pediatrics | 1450 Aviation Dr, Suite 100, Hailey, ID 83333-8785 | 2006-06-09 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.