LAURA A TABOR (NPI# 1538121322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538121322 |
| Entity Type | Individual |
| Full Name | LAURA A TABOR |
| Credential | P.A. |
| Practice Address |
1880 John Adams Pkwy Idaho Falls ID 83401-4315 |
| Practice Telephone | 2085246633 |
| Practice Fax Number | 2085249952 |
| Mailing Telephone | 2085246633 |
| Mailing Fax Number | 2085249952 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2010-07-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA415 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS GROUP | 8K123 | 01 |
| ID | RAILROAD MEDICARE NUMBER | P00205234 | 01 |
| ID | BLUE CROSS PROVIDER NUMBE | PAC63 | 01 |
| ID | REGENCE BLUE SHIELD | 000010156316 | 01 |
| ID | 807659300 | 05 | |
| ID | REGENCE BLUESHIELD GROUP | 000010027582 | 01 |
| ID | BAKER FAMILY GROUP NPI | 1134140148 | 01 |
| ID | 806887600 | 05 | |
| ID | RAILROAD MCR GROUP | DE1614 | 01 |
| Street Address |
1880 JOHN ADAMS PKWY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-4315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386626463 | Wade K Christensen | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2005-11-15 |
| 1457913162 | Jessica Lynne Christensen | Nurse Practitioner | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2019-07-02 |
| 1588948087 | Joshua E Hansen | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2011-10-03 |
| 1639370810 | Wallace Bakers Mid-level Group | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2007-05-29 |
| 1134140148 | Wallace C Baker | Family Medicine | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2006-07-22 |
| 1083696967 | Wallace C Baker | Family Medicine | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386743862 | David Dean Buys | Physician Assistant | 3614 Washington Pkwy, Idaho Falls, ID 83404-7573 | 2006-09-21 |
| 1316910797 | Stephanie Morgan | Physician Assistant | 1660 John Adams Pkwy, Idaho Falls, ID 83401-4360 | 2006-02-08 |
| 1386626463 | Wade K Christensen | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2005-11-15 |
| 1851396519 | Jamie L Carter | Physician Assistant | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2005-06-17 |
| 1609492347 | Jason T Rinker | Physician Assistant | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2020-06-18 |
| 1821645870 | Benjamin J Atwood | Physician Assistant | 3446 S 15th E, Idaho Falls, ID 83404-8262 | 2019-08-23 |
| 1134647019 | Randall James Law | Physician Assistant | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2017-08-31 |
| 1144772237 | Alyssa Jenkins | Physician Assistant | 3820 Crestwood Ln, Idaho Falls, ID 83404 | 2016-10-25 |
| 1093103699 | Tara Powell | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2015-01-05 |
| 1235568742 | Shelley Leilani Davis | Physician Assistant | 3614 Washington Pkwy, Idaho Falls, ID 83404-7573 | 2013-11-05 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on LAURA A TABOR.
| 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.