NUTRITIONAL MEDICINE OF IDAHO (NPI# 1467621383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467621383 |
Entity Type | Organization |
Organization Name | NUTRITIONAL MEDICINE OF IDAHO |
Practice Address |
1520 W State St Suite 220 Boise ID 83702-4085 |
Practice Telephone | 2083433883 |
Practice Fax Number | 2082872010 |
Mailing Telephone | 2083433883 |
Mailing Fax Number | 2082872010 |
Enumeration Date | 2008-02-25 |
Last Update Date | 2008-02-25 |
Authorized Official Name | DR. MATTHEW R MACHA (OWNER) |
Authorized Official Telephone | 2083433883 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
D043 | ID | Dietary & Nutritional Service Providers |
Street Address |
1520 W STATE ST SUITE 220 |
City | BOISE |
State | ID |
Zip Code | 83702-4085 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053311084 | Jessica Anne Briggs | Physician Assistant | 1520 W State St, Suite 100, Boise, ID 83702-4085 | 2005-08-01 |
1124477716 | Collin Reid | Physical Therapist | 1520 W State St, Suite 210, Boise, ID 83702-4085 | 2016-06-06 |
1285000380 | Amelia Doty-jones | Social Worker | 1520 W State St, Boise, ID 83702-4085 | 2015-08-12 |
1508245010 | Madeline Louise Lima | Physician Assistant | 1520 W State St, Boise, ID 83702-4085 | 2015-05-29 |
1316346059 | Michelle P Doran | Nurse Practitioner | 1520 W State St, Ste 100, Boise, ID 83702-4085 | 2014-08-19 |
1114363199 | Catherine Elizabeth Duke | Physical Therapist | 1520 W State St, Ste. 210, Boise, ID 83702-4085 | 2013-05-16 |
1134416647 | Tara S Whitaker | Family Medicine | 1520 W State St, Suite 100, Boise, ID 83702-4085 | 2011-07-05 |
1053624759 | St Lukes Regional Medical Center | Internal Medicine | 1520 W State St, Ste 100, Boise, ID 83702-4085 | 2010-07-22 |
1871769307 | Nicole Barnes | Physical Therapist | 1520 W State St, Ste 210, Boise, ID 83702-4085 | 2008-05-05 |
1992731319 | Capital City Family Medicine Pa | Family Medicine | 1520 W State St, Ste 100, Boise, ID 83702-4084 | 2006-06-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
Find all providers in zip 83702 |
Taxonomy Code | 133NN1002X |
Grouping | Dietary & Nutritional Service Providers |
Classification | Nutritionist |
Specialization | Nutrition, Education |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689281677 | Nola Cannon | Nutritionist | 29677 Hurtz Road, Parma, ID 83660 | 2020-09-24 |
1811519051 | Josette Herdell | Nutritionist | 3183 S Bonnell Rd, Coeur D Alene, ID 83814-6877 | 2020-05-11 |
1073859336 | Lynne Kinson | Nutritionist | 8506 N Maple St, Hayden, ID 83835-8274 | 2012-12-14 |
1447527536 | Mary Ann Stanger | Nutritionist | 3728 N 3700 E, Kimberly, ID 83341-5087 | 2011-11-17 |
1952746125 | Peine Metabolic Wellness Center | Nutritionist | 450 W State St, Suite 250, Eagle, ID 83616-7057 | 2013-05-01 |
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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.