DR. MICHAEL BRYON SPACKMAN


Address: 360 E Montvue Dr, Suite 100, Meridian, ID 83642
Phone: 2088552900

DR. MICHAEL BRYON SPACKMAN (NPI# 1386887032) 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) 1386887032
Entity Type Individual
Full Name DR. MICHAEL BRYON SPACKMAN
Credential MD
Practice Address 360 E Montvue Dr
Suite 100
Meridian
ID 83642
Mailing Address 2835 N Tanglerose Pl
Eagle
ID 83616-5796
Practice Telephone 2088552900
Mailing Telephone 9522395080
Enumeration Date 2009-04-10
Last Update Date 2018-07-11
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2081P2900X Physical Medicine & Rehabilitation
Specialization: Pain Medicine
M11335 ID Allopathic & Osteopathic Physicians

Other Providers MICHAEL SPACKMAN

NPI Name Taxonomy Address Enumeration
1770712978 Michael Lee Spackman Massage Therapist 3112 O St, Suite #1, Sacramento, CA 95816-6542 2009-07-08

Office Location

Street Address 360 E MONTVUE DR
SUITE 100
City MERIDIAN
State ID
Zip Code 83642

Providers in the same location

NPI Name Taxonomy Address Enumeration
1275578908 Edwin Merle Clark Orthopaedic Surgery 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 2006-06-17
1952701401 Southern Idaho Health Partners LLC General Practice 360 E Montvue Dr, Meridian, ID 83642-6318 2014-09-02
1033454426 Sari Bianca Lavarias Physician Assistant 360 E Montvue Dr, Meridian, ID 83642-6318 2012-12-11
1477843811 Tara Osborne Physical Therapist 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 2011-04-18
1770747404 Christian Vanderford Physical Therapist 360 E Montvue Dr, Ste A, Meridian, ID 83642-6318 2008-07-11
1073776258 Liang Wu Internal Medicine 360 E Montvue Dr, Meridian, ID 83642-6318 2008-07-08
1235338682 Kelli Elizabeth Debooy Physical Therapist 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 2007-07-16
1689701260 Shannon L Gardiner Physician Assistant 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 2007-02-28
1659380269 Spine Institute of Idaho P A Orthopaedic Surgery 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 2006-08-05
1962447169 Samuel Steven Jorgenson Orthopaedic Surgery 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 2006-06-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174145684 Ikdo South Meridian LLC Dentist 3839 E Amity Rd, Meridian, ID 83642 2020-05-07
1073133328 Prescription Pad LLC Pharmacy 885 S Vanguard Way, Meridian, ID 83642 2020-04-16
1609412683 Meridian Advanced Psychiatry, LLC Psychiatry & Neurology 1672 S Woodsage Ave., Meridan, ID 83642 2019-11-25
1194378927 Sergey Tsema Occupational Therapist 1259 E Pisa St, Meridian, ID 83642 2019-07-21
1003478629 Chris R Jackson Dentist Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 2019-07-03
1285293118 Morgan Family Medicine Nurse Practitioner 1660 S Woodsage Avenue, Meridian, ID 83642 2019-06-13
1033772793 Nugen Healthcare, Pllc Registered Nurse 2177 S Spoonbill Ave, Meridian, ID 83642 2019-04-18
1811471790 Courtney Crossland Physician Assistant 4949 S Hillsdale Ave., Meridian, ID 83642 2018-09-18
1841771938 Katelyn Perry Counselor 2068 S. Eagle Rd., Meridian, ID 83642 2018-08-27
1114406204 Gem Prep: Meridian LLC Case Management 2750 E.gala Ct., Meridian, ID 83642 2018-08-09
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Taxonomy Information

Taxonomy Code 2081P2900X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Pain Medicine

Taxonomy Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497949705 Idaho Physical Medicine and Rehabilitation Pa Physical Medicine & Rehabilitation 3551 E Overland Road, Meridian, ID 83642 2007-08-29
1427151539 Beth S Rogers Physical Medicine & Rehabilitation 360 E Montvue Dr Ste 100, Meridian, ID 83642-6318 2006-09-06
1396945069 James H Morland, Md Physical Medicine & Rehabilitation 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 2007-07-20
1215975164 James H Morland Physical Medicine & Rehabilitation 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 2006-06-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1598305922 Rebekah Guy Physical Medicine & Rehabilitation 115 W Main St Ste 201, Boise, ID 83702-7303 2020-01-14
1417267329 Idaho Pain Clinic Pllc Physical Medicine & Rehabilitation 1327 Superior St Ste 101, Sandpoint, ID 83864-2742 2010-10-13
1790825842 Mark J Harris Physical Medicine & Rehabilitation 600 W Robbins Rd Ste 300, Boise, ID 83702-4568 2007-02-07
1780769075 Kevin S Hill Physical Medicine & Rehabilitation 777 Hospital Way, Suite G15, Pocatello, ID 83201-5175 2006-10-26
1609885870 N S Support LLC Physical Medicine & Rehabilitation 6140 W Curtisian Ave, Suite 400, Boise, ID 83704 2006-08-06
1710995170 Saint Alphonsus Physicians, Pa Physical Medicine & Rehabilitation 901 N Curtis Rd, Suite 304, Boise, ID 83706-1338 2006-08-03
1023024684 Center for Pain Care P A Physical Medicine & Rehabilitation 115 W Main St, Suite 102, Boise, ID 83702-7302 2006-08-01
1154345585 Clinton Mallari Physical Medicine & Rehabilitation 115 W Main St, Suite 102, Boise, ID 83702-7302 2006-07-27
1356377535 Daniel Richard Marsh Physical Medicine & Rehabilitation 8950 W Emerald St, Ste 168, Boise, ID 83704-8296 2006-06-23
1497711329 Idaho Physical Medicine and Rehabilitation Pa Physical Medicine & Rehabilitation 600 Robbins Rd, Suite #300, Boise, ID 83702-4539 2006-04-20
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Competitor

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City MERIDIAN
Zip Code 83642

Improve Information

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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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