KATIE CLEGG (NPI# 1518597285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750998548 | Katie Clegg | Dietitian, Registered | 2850 Irwin Dr, Southport, NC 28461-8470 | 2020-09-26 |
Street Address |
593 W 24TH ST |
City | BURLEY |
State | ID |
Zip Code | 83318-2803 |
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 |
Find all providers in zip 83318 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
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. |
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 |
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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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.