ADA PLASTIC AND RECONSTRUCTIVE SURGERY (NPI# 1548433790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548433790 |
| Entity Type | Organization |
| Organization Name | ADA PLASTIC AND RECONSTRUCTIVE SURGERY |
| Practice Address |
900 N Liberty St Suite 300 Boise ID 83704-8704 |
| Practice Telephone | 2083676903 |
| Practice Fax Number | 2083676904 |
| Mailing Telephone | 2083676903 |
| Mailing Fax Number | 2083676904 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-11 |
| Authorized Official Name | MR. THOMAS D MCKIM (OWNING PHYSICIAN) |
| Authorized Official Telephone | 2083676901 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
M7009 | ID | Ambulatory Health Care Facilities |
| Street Address |
900 N LIBERTY ST SUITE 300 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-8704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669470274 | Gerard Patrick Connor | Obstetrics & Gynecology | 900 N Liberty St, Ste 101, Boise, ID 83704-8704 | 2005-07-08 |
| 1659909935 | Emily Dawn Clay | Dietitian, Registered | 900 N Liberty St, Boise, ID 83704-8704 | 2020-03-31 |
| 1114455334 | Andrea Suzette Page | Audiologist | 900 N Liberty St, Boise, ID 83704-8704 | 2017-06-01 |
| 1669822672 | Adam Reyes | Audiologist | 900 N Liberty St, 305, Boise, ID 83704-8704 | 2016-06-21 |
| 1346601176 | Melissa Rincon | Massage Therapist | 900 N Liberty St, Boise, ID 83704-8704 | 2016-03-07 |
| 1508268616 | Elizabeth A Rutten-turner | Social Worker | 900 N Liberty St, Suite 200, Boise, ID 83704-8704 | 2014-09-19 |
| 1013342468 | Polina Kokoulina | Physician Assistant | 900 N Liberty St, Ste 101, Boise, ID 83704-8704 | 2013-09-04 |
| 1538456900 | Michael Dean Bateman | Audiologist | 900 N Liberty St, Ste 400, Boise, ID 83704-8704 | 2011-07-06 |
| 1336309434 | Linsey Etherington | Surgery | 900 N Liberty St, Ste 101, Boise, ID 83704-8704 | 2008-06-11 |
| 1487849147 | Saint Alphonsus Physician Services Inc | Advanced Practice Midwife | 900 N Liberty St, Suite 204, Boise, ID 83704-8707 | 2007-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558733147 | River City Surgical Center | Clinic/Center | 10118 W Overland Rd, Boise, ID 83709-1428 | 2015-10-22 |
| 1255500427 | Les Bois Surgery Center, LLP | Clinic/Center | 8950 W Emerald St Ste 164, Boise, ID 83704-8296 | 2008-02-21 |
| 1902960206 | Sinus Surgery Center Idaho Pa | Clinic/Center | 727 E River Park Ln, Suite 200, Boise, ID 83706-4097 | 2006-12-20 |
| 1316961089 | Orthopedic Surgery Center of Idaho, LLC | Clinic/Center | 1425 W River St, Boise, ID 83702-6861 | 2006-07-27 |
| 1750884052 | Precision Surgery Center Pllc | Clinic/Center | 900 N Liberty St Ste 300, Boise, ID 83704-8729 | 2018-03-13 |
| 1629597216 | Genesis Surgery Center | Clinic/Center | 8950 W Emerald St Ste 164, Boise, ID 83704-8296 | 2017-09-14 |
| 1750616249 | Idaho Endoscopy Center LLC | Clinic/Center | 6259 W Emerald St, Boise, ID 83704-8731 | 2009-10-16 |
| 1023228558 | Boise Gastroenterology Associates | Clinic/Center | 6259 W Emerald St, Boise, ID 83704-8731 | 2007-05-23 |
| 1477619005 | Southwest Idaho Surgery Center, Inc. | Clinic/Center | 900 N Liberty St, Suite 450, Boise, ID 83704-8704 | 2006-12-28 |
| 1376607309 | Emerald Surgical Center LLC | Clinic/Center | 811 N Liberty St, Boise, ID 83704-8703 | 2006-12-21 |
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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.