GARY DALE CONDER (NPI# 1538323225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538323225 |
| Entity Type | Individual |
| Full Name | GARY DALE CONDER |
| Credential | ICADC |
| Practice Address |
115 Pima Drive Fort Hall ID 83203-0306 |
| Practice Telephone | 2082382400 |
| Practice Fax Number | 2082385462 |
| Mailing Telephone | 2082382400 |
| Mailing Fax Number | 2082385462 |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
DA116101G | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003399100 | 05 |
| Street Address |
115 PIMA DRIVE |
| City | FORT HALL |
| State | ID |
| Zip Code | 83203-0306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396909024 | Sandra Ortiz | Counselor | 115 Pima Drive, Fort Hall, ID 83203-0306 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154765238 | Chief Tahgee Elementary Academy, Inc. | Local Education Agency (LEA) | 38 South Hiline Road, Fort Hall, ID 83203 | 2013-04-19 |
| 1730304171 | Shari L. Newsome | Social Worker | Mission Road Building 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | 2007-04-13 |
| 1780808899 | Scotti L Brownley | Counselor | Mission Road Bldg 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | 2007-04-12 |
| 1932323045 | Kristy Lee Broncho | Social Worker | Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | 2007-04-12 |
| 1972632834 | Not-tsoo Gah-nee Indian Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Route 6 Mission Rd, Fort Hall, ID 83203 | 2007-03-05 |
| 1346259355 | Holly J Mcgrath | Pharmacist | Mission Rd, Box 717, Fort Hall, ID 83203 | 2006-08-07 |
| 1073518163 | Thomas John Troshynski | Pharmacist | 1 Mission Road, Fort Hall, ID 83203 | 2005-06-16 |
| 1568920080 | Wiley Drew Petersen | Family Medicine | 717 Mission Rd, Fort Hall, ID 83203 | 2019-03-04 |
| 1497262216 | Cameron Jo Marshall | Pharmacist | Mission Road, Fort Hall, ID 83203 | 2018-01-02 |
| 1225570716 | Shoshone-bannock Community Health Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Navajo Drive Bldg 70, Fort Hall, ID 83203 | 2016-11-15 |
| Find all providers in zip 83203 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629232319 | Donna Honena | Counselor | 115 Pima Dr, Fort Hall, ID 83203-0306 | 2008-07-11 |
| 1396909024 | Sandra Ortiz | Counselor | 115 Pima Drive, Fort Hall, ID 83203-0306 | 2008-07-11 |
| 1821252636 | Nava Reneda | Counselor | East Agency Rd, Fort Hall, ID 83203-0306 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1063049682 | Angela Lynn Seal | Counselor | 246 N Curlew Dr Apt 3105, Ammon, ID 83401-1434 | 2020-03-24 |
| 1437785607 | Tamra J Peterson | Counselor | 1246 Yellowstone Ave Bldg F, Pocatello, ID 83201-4374 | 2020-03-19 |
| 1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
| 1265078935 | Mary Amanda Jensen | Counselor | 3990 E 20 N, Rigby, ID 83442-5818 | 2019-11-18 |
| 1689218018 | D6 Treatment | Counselor | 1001 N 7th Ave Ste 260, Pocatello, ID 83201-5788 | 2019-10-29 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1902453509 | James Floyd Young | Counselor | 504 11th Ave S, Nampa, ID 83651-4243 | 2019-08-20 |
| 1508339409 | Joyce Ella Turnboom | Counselor | 3213 N Tamarack Dr, Boise, ID 83703-4543 | 2019-01-03 |
| 1639644107 | Joseph Anomalay | Counselor | 6700 N. Linder Rd, Ste 156 #257, Meridian, ID 83646 | 2018-10-10 |
| Find all providers with the same taxonomy | ||||
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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.