JACQUELINE MAYBACH (NPI# 1568411460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568411460 |
| Entity Type | Individual |
| Full Name | JACQUELINE MAYBACH |
| Credential | M.D. |
| Practice Address |
333 N 1st St Suite 240 Boise ID 83702-6100 |
| Practice Telephone | 2083388900 |
| Practice Fax Number | 2083312418 |
| Mailing Telephone | 2083388900 |
| Mailing Fax Number | 2083312418 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | M-7973 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
333 N 1ST ST SUITE 240 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935966 | Heidi Louise Nagel | Genetic Counselor, MS | 333 N 1st St, Suite 150, Boise, ID 83702-6100 | 2006-01-05 |
| 1558715235 | Laura Mae Defenbach | Genetic Counselor, MS | 333 N 1st St, Suite 150, Boise, ID 83702-6100 | 2016-04-19 |
| 1558799270 | Nita M Barrelier Verner | Nurse Practitioner | 333 N 1st St, Suite #140, Boise, ID 83702-6100 | 2013-10-15 |
| 1780949164 | Cortney Lynn Schnupp | Nurse Practitioner | 333 N 1st St, 240, Boise, ID 83702-6100 | 2012-07-11 |
| 1538476239 | Tyler S Stewart | Physician Assistant | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-09-02 |
| 1659699841 | St Luke's Regional Medical Center | Surgery | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-05-12 |
| 1366675985 | Sarah R. Sparks | Nurse Practitioner | 333 N 1st St, Suite 140, Boise, ID 83702-6100 | 2009-08-30 |
| 1730311564 | Aaron L Thomason | Nurse Practitioner | 333 N 1st St, Suite 280, Boise, ID 83702-6100 | 2009-08-12 |
| 1558508085 | Beau G Walker | Physician Assistant | 333 N 1st St, Suite 280, Boise, ID 83702-6100 | 2009-01-21 |
| 1295900744 | Jordan D Keyes | Spec/Tech, Cardiovascular | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2008-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295001170 | Anne Feighner | Obstetrics & Gynecology | 400 E Idaho St #400, St. Luke's Clinic - The Woman's Clinic, Boise, ID 83712 | 2012-03-26 |
| 1497790075 | Horizon Health Pa | Obstetrics & Gynecology | 311 W Idaho St, Boise, ID 83702-6040 | 2006-06-18 |
| 1588605364 | Patricia Ann Caplinger | Obstetrics & Gynecology | 1055 W. Curtis Rd, Boise, ID 83706-1309 | 2006-06-10 |
| 1740255504 | Shashi Ajmani | Obstetrics & Gynecology | 1072 N Liberty, Suite 100, Boise, ID 83704-8708 | 2006-02-22 |
| 1366435687 | Lauren D. Bales | Obstetrics & Gynecology | 1055 N Curtis Road, Boise, ID 83706 | 2005-08-23 |
| 1316333107 | Karissa Deann Keenan | Obstetrics & Gynecology | 1072 N Liberty St, Ste 100, Boise, ID 83704 | 2015-04-08 |
| 1932547338 | Paula Jean Durst | Obstetrics & Gynecology | 1055 N Curtis Rd, Boise, ID 83706 | 2013-06-06 |
| 1033554480 | Maryalice Lopez | Obstetrics & Gynecology | 333 N 1st St Ste 240, Boise, ID 83702-6132 | 2013-04-29 |
| 1790028405 | Jessica Marie Riordan | Obstetrics & Gynecology | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2013-04-01 |
| 1154680072 | Eve Preus | Obstetrics & Gynecology | 1072 N Liberty, Ste 100, Boise, ID 83704 | 2012-05-12 |
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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.