DEREK KOHLHASE (NPI# 1407410830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407410830 |
| Entity Type | Individual |
| Full Name | DEREK KOHLHASE |
| Credential | MD |
| Practice Address |
215 E Hawaii Ave Nampa ID 83686-6011 |
| Mailing Address |
777 N Raymond St Boise ID 83704-9251 |
| Practice Telephone | 2085142529 |
| Practice Fax Number | 2083752217 |
| Mailing Telephone | 2085142500 |
| Mailing Fax Number | 2083752217 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MRM-1814 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
215 E HAWAII AVE |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-6011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740668 | Peter Stevan Jerome | Internal Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-06-14 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 83686 | ||||
| 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 |
|---|---|---|---|---|
| 1669038220 | Savannah M Klinginsmith | Family Medicine | 17866 Polara Way, Nampa, ID 83687-9159 | 2019-05-18 |
| 1396278958 | Sean Michael Rutschke | Family Medicine | 9850 W St Lukes Dr Ste 290, Nampa, ID 83687-7912 | 2017-04-10 |
| 1407204225 | Sarah M Waterman | Family Medicine | 9850 W St Lukes Dr Ste 329, Nampa, ID 83687-7912 | 2016-06-02 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1588036396 | Andrew Leon Bennett | Family Medicine | 5102 Howard Ln, Nampa, ID 83687-8659 | 2015-10-21 |
| 1881033256 | Mitchell A Mendenhall | Family Medicine | 11035 Karcher Rd, Nampa, ID 83651-8200 | 2013-06-19 |
| 1487949475 | Erik Steven Linn | Family Medicine | 11035 W. Karcher Road, Nampa, ID 83651 | 2011-06-17 |
| 1174834246 | Josh Leavitt | Family Medicine | 974 W Corporate Ln Ste 102, Nampa, ID 83651-1930 | 2010-06-23 |
| 1427099852 | Linda Lam | Family Medicine | 1510 12th Ave Rd, Ste 200, Nampa, ID 83686 | 2006-06-09 |
| 1548228844 | Austin J. Graham | Family Medicine | 824 S Diamond St, Nampa, ID 83686-5960 | 2006-05-03 |
| Find all providers in NAMPA | ||||
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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.