KALEB REDDEN


Address: 777 N Raymond St, Boise, ID 83704-9251
Phone: 2085142500

KALEB REDDEN (NPI# 1366822892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366822892
Entity Type Individual
Full Name KALEB REDDEN
Credential DO
Practice Address 777 N Raymond St
Boise
ID 83704-9251
Practice Telephone 2085142500
Practice Fax Number 2083752217
Mailing Telephone 2085142500
Mailing Fax Number 2083752217
Enumeration Date 2015-05-29
Last Update Date 2019-06-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
O-0995 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ID 1366822892 05

Office Location

Street Address 777 N RAYMOND ST
City BOISE
State ID
Zip Code 83704-9251

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578566253 Jeffrey Karl Edwards Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2005-05-24
1619599347 Kim Mcgrath Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1437771169 Kevin Mcnamee Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1003438730 Tracy Adams Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1093337727 Angela Bangs Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1902428634 Amanda Aman Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1275155905 Paige Ely Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1457973182 Zara Bowden Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1992327621 Kelsey Harding Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
1366064099 Jeffrey Chase Family Medicine 777 N Raymond St, Boise, ID 83704-9251 2020-05-15
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215535893 Laura Diggs Counselor 400 North Benjamin Lane, Suite 200, Boise, ID 83704 2020-10-15
1891304002 Tree City Family Dental Dentist 7301 W. Emerald St Ste. 102, Boise, ID 83704 2020-07-24
1982230710 Jessica Wynn Councell Midwife 1072 N Liberty St Ste 100, Boise, ID 83704 2020-03-12
1699307124 Isabel Burns Bruce Registered Nurse 777 N Raymond Street, Boise, ID 83704 2020-02-12
1558903328 Daring In Idaho, LLC Social Worker 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 2019-10-14
1053960286 Kyle Hiromi Hatanaka Acupuncturist 9450 #120 Fairview Avenue, Boise, ID 83704 2019-09-10
1700447141 Katie Elizabeth Nichols Physician Assistant 1072 N Liberty St Ste 201, Boise, ID 83704 2019-06-26
1588164727 Cory Michael Sims Counselor 6550 W. Emerald St #112, Boise, ID 83704 2018-02-14
1477072270 Matthew Lee Love Non-emergency Medical Transport (VAN) 6933 W. Stratton St, Boise, ID 83704 2017-09-12
1942735949 Dalana Sue Thompson Counselor 9196 Emerald St Suite #130, Boise, ID 83704 2017-04-27
Find all providers in zip 83704

Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508152257 Tobias P Gopon Family Medicine 600 N Robbins Rd Ste 400, Boise, ID 83702-4566 2011-06-21
1215137526 Dean Edward Lapinel Family Medicine 1437 E Braemere Rd, Boise, ID 83702-1857 2007-07-24
1881629202 Craig M Smith Family Medicine 5959 N Discovery Place, Boise, ID 83713-1556 2006-07-12
1477581122 Kurt J Nilsson Family Medicine 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 2006-06-30
1417143926 Richard Radnovich Do PC Family Medicine 4850 N Rosepoint Way, Suite 100, Boise, ID 83713-5262 2007-09-18
1407944655 Richard Radnovich Family Medicine 4850 N Rosepoint Way, Ste 100, Boise, ID 83713 2006-10-11
1518978337 Alejandro A Homaechevarria Family Medicine 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 2006-08-10
1043216823 Scot B Scheffel Family Medicine 1188 University Dr, Boise, ID 83706 2005-06-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407237043 Jacob Kent Christensen Family Medicine 831 S Ash St, Moscow, ID 83843 2015-06-09
1801292115 Idaho State University Family Medicine 921 S 8th Ave Stop 8173, Sports and Orthopaedic Center, Pocatello, ID 83209-8173 2014-11-13
1659870517 Orthoidaho LLC Family Medicine 2240 E Center St, Pocatello, ID 83201-2600 2018-02-06
1295094217 James Kendall Christensen Family Medicine 2375 E Sunnyside Rd, Ste F, Idaho Falls, ID 83404-8280 2012-05-11
1770877888 Anthony Joseph Md Inc Family Medicine 333 N 18th Ave, Suite D-1, Pocatello, ID 83201-3358 2011-06-06
1033417035 Idaho Sports & Spine Pllc Family Medicine 950 Hospital Way, Ste A, Pocatello, ID 83201-2789 2011-03-01
1124115944 Tony C Roisum Md Pa Family Medicine 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404-8333 2006-10-05
1528092202 Christopher R Johnson Family Medicine 950 Hospital Way, Suite A, Pocatello, ID 83201-2789 2006-07-10
1922092741 Anthony E Joseph Family Medicine 2240 E Center St, Pocatello, ID 83201-2600 2005-09-08

Competitor

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City BOISE
Zip Code 83704

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Dataset Information

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.

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