NUTRITIONAL MEDICINE OF IDAHO


Address: 1520 W State St, Suite 220, Boise, ID 83702-4085
Phone: 2083433883

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133NN1002X Nutritionist
Specialization: Nutrition, Education
D043 ID Dietary & Nutritional Service Providers

Office Location

Street Address 1520 W STATE ST
SUITE 220
City BOISE
State ID
Zip Code 83702-4085

Providers in the same location

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
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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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
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Taxonomy Information

Taxonomy Code 133NN1002X
Grouping Dietary & Nutritional Service Providers
Classification Nutritionist
Specialization Nutrition, Education

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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

Competitor

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City BOISE
Zip Code 83702

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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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