PETRIE WHITE FAMILY MEDICINE OF IDAHO (NPI# 1447629555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447629555 |
| Entity Type | Organization |
| Organization Name | PETRIE WHITE FAMILY MEDICINE OF IDAHO |
| Other Organization Name | EMMETT FAMILY MEDICINE AND DIRECT PRIMARY CARE |
| Practice Address |
2001 E Quail Run Rd Emmett ID 83617-5059 |
| Practice Telephone | 2083657131 |
| Practice Fax Number | 2083654464 |
| Mailing Telephone | 2083657131 |
| Mailing Fax Number | 2083654464 |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2016-01-12 |
| Authorized Official Name | MR. RYAN EARL WHITE (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 2083657131 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M7802 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805196400 | 05 |
| Other Name | Type Code |
|---|---|
| Emmett Family Medicine and Direct Primary Care | Doing Business As Name - Organization |
| Street Address |
2001 E QUAIL RUN RD |
| City | EMMETT |
| State | ID |
| Zip Code | 83617-5059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891879094 | Jennifer Petrie | Family Medicine | 2001 E Quail Run Rd, Emmett, ID 83617-5059 | 2006-10-24 |
| 1285278614 | Holly Suzanne Peterson | Physician Assistant | 2001 E Quail Run Rd, Emmett, ID 83617-5059 | 2019-10-29 |
| 1437625662 | Isabella M Satterthwait | Physician Assistant | 2001 E Quail Run Rd, Emmett, ID 83617-5059 | 2018-10-15 |
| 1851721401 | Joseph W Petrie | Physician Assistant | 2001 E Quail Run Rd, Emmett, ID 83617-5059 | 2013-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375659 | Jonathan Barrus Do PC | Family Medicine | 2020 S Johns Avenue, Emmett, ID 83617 | 2020-10-29 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1699248054 | Lisa Southard | Social Worker | 825 S. Washington Avenue, Emmett, ID 83617 | 2019-01-09 |
| 1396069712 | Kelsey Peterson | Dentist | 1312 South Washington Street, Emmett, ID 83617 | 2010-03-15 |
| 1598907073 | Bimart Corporation | Durable Medical Equipment & Medical Supplies | 179 West Highway 52, Emmett, ID 83617 | 2009-03-31 |
| 1548401169 | Cynthia K. Rokey | Massage Therapist | 3777 S. Johns Ave, Emmett, ID 83617 | 2009-03-11 |
| 1407984966 | Jill Janay Sprague | Counselor | 113 N Commercial, Emmett, ID 83617 | 2007-02-28 |
| 1548320252 | Jo Anna Henson1 | Homemaker | 2020 Ua Ave Sp 14, Emmett, ID 83617 | 2006-12-11 |
| 1922193200 | Nancy Susanne Nickerson | Physical Therapist | 809 S Washington, Emmett, ID 83617 | 2006-10-04 |
| 1083707277 | Michael S Lee | Social Worker | 2007 S Plaza, Suite #1, Emmett, ID 83617 | 2006-10-02 |
| Find all providers in zip 83617 | ||||
| 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 |
|---|---|---|---|---|
| 1699375659 | Jonathan Barrus Do PC | Family Medicine | 2020 S Johns Avenue, Emmett, ID 83617 | 2020-10-29 |
| 1316284490 | Idaho Behavioral Health, Inc. | Family Medicine | 315 S Johns Ave, Emmett, ID 83617-3030 | 2013-01-10 |
| 1720362775 | Gem Family Medicine LLC | Family Medicine | 1108 South Washington Ave, Emmett, ID 83617-3535 | 2011-10-07 |
| 1891879094 | Jennifer Petrie | Family Medicine | 2001 E Quail Run Rd, Emmett, ID 83617-5059 | 2006-10-24 |
| 1629188644 | Klint Howard Stander | Family Medicine | 1202 E Locast St, Walter Knox Memorial Hospital, Emmett, ID 83617 | 2006-08-30 |
| 1306873435 | Tina A Mcguffey | Family Medicine | 426 Highway 16, Emmett, ID 83617-9461 | 2006-06-26 |
| 1154357614 | The Smith Clinic | Family Medicine | 119 N Wardwell Ave, Emmett, ID 83617-3040 | 2006-06-24 |
| 1679574487 | Bryan Stone | Family Medicine | 207 E 12th St, Emmett, ID 83617-3626 | 2005-08-02 |
| 1811419708 | Black Canyon Medical Group Pllc | Family Medicine | 426 Highway 16, Emmett, ID 83617-9461 | 2017-07-12 |
| 1649300138 | Black Canyon Family Medicine PC | Family Medicine | 119 N Wardwell Ave, Emmett, ID 83617-3040 | 2007-03-06 |
| Find all providers in EMMETT | ||||
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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.