ALLIANCE MEDICAL GROUP, LLC (NPI# 1407092794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407092794 |
| Entity Type | Organization |
| Organization Name | ALLIANCE MEDICAL GROUP, LLC |
| Other Organization Name | PRIMARY HEALTH MEDICAL GROUP |
| Practice Address |
1648 Nw 1st Street Meridian ID 83642 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2088889393 |
| Practice Fax Number | 2088889525 |
| Mailing Telephone | 2089556500 |
| Mailing Fax Number | 2089556503 |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2016-12-09 |
| Authorized Official Name | DAVID PETERMAN (PRESIDENT) |
| Authorized Official Telephone | 2089556506 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primary Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1033534276 | Alliance Medical Group, LLC | Family Medicine | 1623 South Wells Avenue, Meridian, ID 83642 | 2014-02-25 |
| 1770729063 | Alliance Medical Group, LLC | Pediatrics | 3280 E. Lanark Drive, Meridian, ID 83642 | 2008-12-17 |
| 1497991749 | Alliance Medical Group, LLC | Family Medicine | 1907 Broadway Ave, Suite 101, Boise, ID 83706-4201 | 2008-12-16 |
| 1568413920 | Alliance Medical Group, LLC | Family Medicine | 10482 W Carlton Bay Dr, Garden City, ID 83714-5143 | 2006-05-12 |
| 1124641188 | Alliance Medical Group, LLC | Family Medicine | 1475 N Cole Rd, Boise, ID 83704-8537 | 2020-05-26 |
| 1073079463 | Alliance Medical Group, LLC | Family Medicine | 512 N 21st Ave, Caldwell, ID 83605-4368 | 2019-02-11 |
| 1457868002 | Alliance Medical Group, LLC | Family Medicine | 1375 N Happy Valley Rd, Nampa, ID 83687-5280 | 2018-01-04 |
| 1386003770 | Alliance Medical Group, LLC | Family Medicine | 1900 W. Chinden Blvd., Meridian, ID 83646 | 2016-02-15 |
| Street Address |
1648 NW 1ST STREET |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225027253 | Timothy P Hodges | Family Medicine | 1648 Nw 1st Street, Meridian, ID 83642 | 2005-10-21 |
| 1306390380 | Suzanne Jardine | Nurse Practitioner | 1648 Nw 1st Street, Meridian, ID 83642-2720 | 2016-08-08 |
| 1376707034 | Mark A Johnson | Family Medicine | 1648 Nw 1st Street, Meridian, ID 83642 | 2008-07-11 |
| 1831264878 | Lloyd D Stolworthy | General Practice | 1648 Nw 1st Street, Meridian, ID 83642 | 2006-11-22 |
| 1164450862 | Jeremy Daniel Frix | Physician Assistant | 1648 Nw 1st Street, Meridian, ID 83642 | 2006-06-29 |
| 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 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| 1023506466 | Vast Durable Medical Equipment Inc | Family Medicine | 2985 S Meridian Rd Ste 140, Meridian, ID 83642-7961 | 2018-04-30 |
| 1235651498 | Carmeshia M Cain | Family Medicine | 1312 22nd Ave Ste A, Meridian, MS 39301-4015 | 2017-07-10 |
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1619397064 | Sara Jane Aney | Family Medicine | 4949 S Hillsdale Ave, Meridian, ID 83642-7586 | 2014-04-24 |
| 1033534276 | Alliance Medical Group, LLC | Family Medicine | 1623 South Wells Avenue, Meridian, ID 83642 | 2014-02-25 |
| 1275979346 | Matthew Robert Sara | Family Medicine | 1648 Nw 1st St, Meridian, ID 83642-2212 | 2013-05-16 |
| 1093074577 | Marisa A Battaglia | Family Medicine | 1623 Wells Ave, Meridian, ID 83642-5040 | 2012-05-03 |
| 1891051942 | Louise Xian Ye-liew | Family Medicine | 2965 East Tarpon, Suite 150, Meridian, ID 83642 | 2012-04-03 |
| 1912221318 | Unity Health Center Pllc | Family Medicine | 1130 E Fairview Ave, Meridian, ID 83642-1813 | 2010-03-15 |
| Find all providers in MERIDIAN | ||||
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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.