TWO RIVERS MEDICAL CLINIC, PA (NPI# 1376662486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376662486 |
| Entity Type | Organization |
| Organization Name | TWO RIVERS MEDICAL CLINIC, PA |
| Practice Address |
683 E 3rd St Weiser ID 83672-2248 |
| Mailing Address |
Po Box 871 Weiser ID 83672-0001 |
| Practice Telephone | 2085490211 |
| Practice Fax Number | 2085490104 |
| Mailing Telephone | 2085490211 |
| Mailing Fax Number | 2085490104 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2016-04-12 |
| Authorized Official Name | TONY EDMONDSON (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 2085490211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 002756600 | 05 | |
| ID | 805040300 | 05 | |
| ID | 002756300 | 05 | |
| ID | 1376662486 | 05 |
| Street Address |
683 E 3RD ST |
| City | WEISER |
| State | ID |
| Zip Code | 83672-2248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477506053 | Suzanna Dyann Hubele | Family Medicine | 683 E 3rd St, Weiser, ID 83672-2248 | 2006-05-18 |
| 1649365404 | Lore Beth Wootton | Family Medicine | 683 E 3rd St, Weiser, ID 83672-2248 | 2006-10-04 |
| 1497840292 | Selena Jeanette Ankarberg | Nurse Practitioner | 683 E 3rd St, Weiser, ID 83672-2248 | 2006-10-04 |
| 1316032261 | Deland Ray Barr | Family Medicine | 683 E 3rd St, Weiser, ID 83672-2248 | 2006-10-04 |
| 1821183617 | Kent Leroy Hamilton | Physician Assistant | 683 E 3rd St, Weiser, ID 83672-2248 | 2006-10-04 |
| 1093800872 | Edward Robert Wheeler | Family Medicine | 683 E 3rd St, Weiser, ID 83672-2248 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891176798 | Christine Cooper | Nurse Practitioner | 35 W Idaho St, Weiser, ID 83672 | 2015-06-16 |
| 1356630941 | Jordan V Blanchard | Family Medicine | 360 E. Liberty, Weiser, ID 83672 | 2011-04-04 |
| 1427038231 | Christopher Earl Malloy | Dentist | 1067 Hwy 95, Weiser, ID 83672 | 2006-01-18 |
| 1457508418 | Christy Earlean Marvin | Home Health Aide | 1111 E Main St, Weiser, ID 83672 | 2008-08-21 |
| 1255364030 | Weiser Valley Hospital District | Orthopaedic Surgery | 645 E. 5th St., Weiser, ID 83672 | 2006-07-07 |
| 1568685543 | Weiser School District #431 | Specialist | 925 Pioneer Rd, Weiser, ID 83672-1146 | 2007-04-10 |
| 1275147712 | Madison Caldwell | Counselor | 925 Pioneer Rd, Weiser, ID 83672-1146 | 2020-09-02 |
| 1588108872 | Laura Haun | Specialist/Technologist | 275 Mcginnis Dr, Weiser, ID 83672-1262 | 2016-12-06 |
| 1073537486 | Bi-mart Corporation | Durable Medical Equipment & Medical Supplies | 1545 E 6th St, Weiser, ID 83672-1495 | 2006-07-27 |
| 1164047635 | Bridget Moore | Pharmacy Technician | 1545 E 6th St, Weiser, ID 83672-1495 | 2020-06-10 |
| Find all providers in zip 83672 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1568950566 | North Canyon Medical Center, Inc. | Clinic/Center | 718 Hwy 30, Buhl, ID 83316 | 2018-04-25 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1700206588 | Mvh Bmc LLC | Clinic/Center | 210 S Emerson Ave, Shelley, ID 83274-1229 | 2014-04-21 |
| 1922243088 | Bmh Inc | Clinic/Center | 1355 Parkway Dr, Blackfoot, ID 83221-1656 | 2008-12-03 |
| 1023271731 | Upper Valley Family Medicine Rhc | Clinic/Center | 530 Rigby Lake Dr, Rigby, ID 83442-1271 | 2008-07-03 |
| 1891984167 | Bmh Inc | Clinic/Center | 1425 Parkway Drive, Blackfoot, ID 83221-1758 | 2007-10-23 |
| 1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
| 1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
| 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.