PETER STEVAN JEROME


Address: 215 E Hawaii Ave, Nampa, ID 83686-6011
Phone: 2084633000

PETER STEVAN JEROME (NPI# 1396740668) 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) 1396740668
Entity Type Individual
Full Name PETER STEVAN JEROME
Credential M.D.
Practice Address 215 E Hawaii Ave
Nampa
ID 83686-6011
Mailing Address 1000 1st Dr Nw
Austin
MN 55912-2941
Practice Telephone 2084633000
Practice Fax Number 2084633035
Mailing Telephone 5074337351
Enumeration Date 2005-06-14
Last Update Date 2019-09-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
12731 ND Allopathic & Osteopathic Physicians
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
M-12784 ID Allopathic & Osteopathic Physicians
N 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
51376 MN Allopathic & Osteopathic Physicians
N 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
23793 WI Allopathic & Osteopathic Physicians
N 207RS0012X Internal Medicine
Specialization: Sleep Medicine
M-12784 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN RAILROAD MEDICARE P00849680 01
WI 31692500 05
IA ENROLLED 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1000 1st Dr Nw, Austin, MN 559122941 5074337351

Office Location

Street Address 215 E HAWAII AVE
City NAMPA
State ID
Zip Code 83686-6011

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174145809 Carolyn Knackstedt Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-05-15
1609498336 Houston Reynolds Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-05-15
1427670157 Ali Sup Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-05-15
1710509443 Rory Hawker Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-05-15
1689295180 Patricia J Funkhouser Nurse Practitioner 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-05-06
1275169252 Ashley Whitlow Nurse Practitioner 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-03-21
1669002721 Nicole Webb Physician Assistant 215 E Hawaii Ave, Nampa, ID 83686-6011 2020-01-16
1548824964 Catherine Heil Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2019-05-01
1174187587 Mark Dahle Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2019-05-01
1407410830 Derek Kohlhase Family Medicine 215 E Hawaii Ave, Nampa, ID 83686-6011 2019-05-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184255960 Kristine Lynn Fitts-eisenbrandt Social Worker 270 W. Gerogia Ave., Nampa, ID 83686 2020-01-30
1669025706 Vitality Family Chiropractic, Pllc Chiropractor 3189 E Greenhurst Rd, Nampa, ID 83686 2019-07-18
1871150185 King's Peak Investments, Inc. Substance Abuse Rehabilitation Facility 8898 Idaho 45, Nampa, ID 83686 2019-05-22
1154805786 Jmj Nampa LLC Dentist 914 12th Ave Rd, Nampa, ID 83686 2018-09-19
1518448703 Michel Cox Pharmacy Technician 2219 12th Ave S, Nampa, ID 83686 2018-08-24
1437504909 5 Peppers Inc Family Medicine 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 2016-05-03
1811369549 Anna Stoia Physician Assistant 4401 E. Tuscany Ave., Nampa, ID 83686 2015-10-21
1144699307 Jamie Green Social Worker 112 12th Avenue Rd., Nampa, ID 83686 2015-09-17
1174927933 Bower Chiropractic Inc Chiropractor 304 12th Ave Rd, Nampa, ID 83686 2014-10-22
1285037093 Rosemary Phelps Registered Nurse 353 W. Iowa, Nampa, ID 83686 2014-10-07
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932169042 Cary V. Jackson Internal Medicine 401 E Hawaii, Nampa, ID 83686 2006-03-23
1275979692 Katarzyna Kaczmarczyk Internal Medicine 4400 E Flamingo Ave, Ste 200, Nampa, ID 83687 2013-05-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407124753 Idaho Falls Pulmonary Sleep & Critical Care Specialists Internal Medicine 2442 E 25th St, Idaho Falls, ID 83404-7549 2011-12-01
1831423557 Idagem Services Inc Internal Medicine 1533 N Milwaukee St, Ste 321, Boise, ID 83704-8471 2009-09-28
1417102930 Joshua David Holweger Internal Medicine 1075 N Curtis, Ste 200, Boise, ID 83706-1350 2008-11-25
1659407716 Richard Keith Oehlschlager Internal Medicine 3036 Lakewood Way, Boise, ID 83706-5240 2007-02-25
1194861534 Richard J Robinson Internal Medicine 700 West Ironwood Drive, Suite 336, Coeur D'alene, ID 83814-4485 2007-01-30
1013946391 Janat E. O'donnell Internal Medicine 1075 N. Curtis Rd, Suite 200, Boise, ID 83706-1300 2006-06-30
1528002029 Ronald F Fullmer Internal Medicine 570 Shoup Ave W, Twin Falls, ID 83301-5029 2006-06-15
1932191319 Peter Lawrence Fort Internal Medicine 777 Hospital Way Ste 202, Pocatello, ID 83201-5175 2005-08-22
1932769700 Gritman Medical Center Inc Internal Medicine 700 S Main St, Moscow, ID 83843-3046 2019-06-14
1073027389 Jordan Joseph Cormier Internal Medicine 2330 Desoto St, Idaho Falls, ID 83404-7570 2017-11-22
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Competitor

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City NAMPA
Zip Code 83686

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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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