KATIE CLEGG


Address: 593 W 24th St, Burley, ID 83318-2803
Phone: 5416904925

KATIE CLEGG (NPI# 1518597285) 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) 1518597285
Entity Type Individual
Full Name KATIE CLEGG
Credential RTR
Practice Address 593 W 24th St
Burley
ID 83318-2803
Practice Telephone 5416904925
Mailing Telephone 5416904925
Enumeration Date 2020-01-22
Last Update Date 2020-01-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
910569 OR Allopathic & Osteopathic Physicians
N 106S00000X Behavior Technician Behavioral Health & Social Service Providers

Other Providers KATIE CLEGG

NPI Name Taxonomy Address Enumeration
1750998548 Katie Clegg Dietitian, Registered 2850 Irwin Dr, Southport, NC 28461-8470 2020-09-26

Office Location

Street Address 593 W 24TH ST
City BURLEY
State ID
Zip Code 83318-2803

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902366834 Pain & Spine Consultants Clinic/Center 1344 Hiland Avenue, Ste A, Burley, ID 83318 2019-03-25
1609335090 Hurst Medical Pllc Clinic/Center 1700 Overland Ave Ste 1, Burley, ID 83318 2019-03-15
1831654243 Mini-cassia Hearts 4 Seniors In Home Supportive Care 135 East 23rd Drive, Burley, ID 83318 2019-02-11
1841760493 Burley Family Dental Pllc Dentist 2200 Parke Ave Ste 2, Burley, ID 83318 2018-11-27
1831634823 Skye Fahnlander Occupational Therapy Assistant 2303 Parke Ave, Burley, ID 83318 2016-12-29
1285024497 Albion Valley Health Clinic Inc. Clinic/Center 400 West 5th Street, Burley, ID 83318 2015-01-26
1124372370 A Plus Solutions Center Clinic/Center 2311 Parke Ave. Unit 3, Suite 12, Burley, ID 83318 2012-11-08
1831442805 A Plus Solutions Developmental Center LLC Day Training, Developmentally Disabled Services 2251 Overland Avenue, Suite Number 5, Burley, ID 83318 2012-10-16
1619258159 Keleah Margrete Goldammer Occupational Therapist 2303 Parke Avenue, Burley, ID 83318 2011-08-29
1932490984 Tamera Chatburn Counselor 531 East 5th St., Preferred Child and Family Services, Burley, ID 83318 2011-04-26
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053597237 Mountain Medical Physician Specialists of Idaho PC Radiology 1501 Hiland Ave, Burley, ID 83318-2682 2008-01-17
1225172661 Spencer John Robertson Radiology 1501 Hiland Ave, Burley, ID 83318-2682 2007-02-19
1487600029 Marvin J. Friedenberg Radiology 1501 Hiland Ave, Burley, ID 83318-2682 2006-05-25
1255385837 F. B. Fitts Jr., M.d. PC Radiology 1344 Hiland Ave, Burley, ID 83318-1564 2006-05-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1376920553 Creighton Lewis Radiology 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 2015-04-27
1598176448 Derek A Khorsand Radiology Kootenai Health, 2003 Kootenai Way, Coeur D'alene, ID 83814 2014-05-14
1578903191 Miriam Bryna Hulkower Radiology 1839 N Govt Way Ste B, Coeur D Alene, ID 83814-3454 2013-06-27
1750647913 Philip John Dougherty Radiology 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 2012-04-02
1356510143 Newell Kay Richardson Radiology 2088 E 49th South, Idaho Falls, ID 83404-7649 2008-02-26
1477733574 Cameron J Evans Radiology 4121 N 2600 E, Filer, ID 83328-5155 2007-11-06
1295926061 Michael Modica Radiology 877 W Main St, Suite 603, Boise, ID 83702-5883 2007-08-07
1972709590 Stephen Arthur Sherman Radiology 4685 Flora Dr, Pocatello, ID 83204-4568 2007-06-21
1891999165 Vidvuds Bandrevics Radiology 102 Canyon Rd, Hailey, ID 83333-5067 2007-06-12
1346457298 John Charles Kirkham Radiology 115 W Main St Ste 202, Boise, ID 83702-7303 2007-05-17
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Competitor

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City BURLEY
Zip Code 83318

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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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