ALLIANCE MEDICAL GROUP, LLC (NPI# 1568608800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568608800 |
| Entity Type | Organization |
| Organization Name | ALLIANCE MEDICAL GROUP, LLC |
| Other Organization Name | PRIMARY HEALTH MEDICAL GROUP |
| Practice Address |
6052 W State St Boise ID 83703-2739 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2083447799 |
| Practice Fax Number | 2083447152 |
| Mailing Telephone | 2089556500 |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2011-02-18 |
| Authorized Official Name | DAVID PETERMAN (PRESIDENT) |
| Authorized Official Telephone | 2089556522 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Primary Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1033534276 | Alliance Medical Group, LLC | Family Medicine | 1623 South Wells Avenue, Meridian, ID 83642 | 2014-02-25 |
| 1770729063 | Alliance Medical Group, LLC | Pediatrics | 3280 E. Lanark Drive, Meridian, ID 83642 | 2008-12-17 |
| 1497991749 | Alliance Medical Group, LLC | Family Medicine | 1907 Broadway Ave, Suite 101, Boise, ID 83706-4201 | 2008-12-16 |
| 1568413920 | Alliance Medical Group, LLC | Family Medicine | 10482 W Carlton Bay Dr, Garden City, ID 83714-5143 | 2006-05-12 |
| 1124641188 | Alliance Medical Group, LLC | Family Medicine | 1475 N Cole Rd, Boise, ID 83704-8537 | 2020-05-26 |
| 1073079463 | Alliance Medical Group, LLC | Family Medicine | 512 N 21st Ave, Caldwell, ID 83605-4368 | 2019-02-11 |
| 1457868002 | Alliance Medical Group, LLC | Family Medicine | 1375 N Happy Valley Rd, Nampa, ID 83687-5280 | 2018-01-04 |
| 1386003770 | Alliance Medical Group, LLC | Family Medicine | 1900 W. Chinden Blvd., Meridian, ID 83646 | 2016-02-15 |
| Street Address |
6052 W STATE ST |
| City | BOISE |
| State | ID |
| Zip Code | 83703-2739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386635977 | Nathan John Church | Physician Assistant | 6052 W State St, Boise, ID 83703-2739 | 2005-11-02 |
| 1275175291 | Hailey M Gordon | Nurse Practitioner | 6052 W State St, Boise, ID 83703-2739 | 2019-10-10 |
| 1659939031 | Brian C Cey | Nurse Practitioner | 6052 W State St, Boise, ID 83703-2739 | 2019-05-31 |
| 1467803957 | Brenna Elizabeth Sweeney | Specialist/Technologist | 6052 W State St, Boise, ID 83703-2739 | 2016-06-25 |
| 1033595905 | Ryan Anthony Baugher | Family Medicine | 6052 W State St, Boise, ID 83703-2739 | 2015-08-03 |
| 1871904698 | Matthew Mors | Otolaryngology | 6052 W State St, Boise, ID 83703-2739 | 2014-05-14 |
| 1285068056 | Valerie Romanello | Physical Therapist | 6052 W State St, Boise, ID 83703-2739 | 2013-08-28 |
| 1902230923 | Barbara Susan Kerr | Physical Therapist | 6052 W State St, Boise, ID 83703-2739 | 2013-08-27 |
| 1245522036 | Kelly Catherine Wilkinson | Family Medicine | 6052 W State St, Boise, ID 83703-2739 | 2011-05-11 |
| 1396981643 | Alliance Medical Group, LLC | Family Medicine | 6052 W State St, Boise, ID 83703-2739 | 2008-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1043545106 | Ashwood Recovery LLC. | Clinic/Center | 7941 W Rifleman St, Boise, ID 83704-9001 | 2009-10-07 |
| 1568005809 | Pure Healthcare of Idaho LLC | Clinic/Center | 6560 W Emerald St Ste 122, Boise, ID 83704-8781 | 2019-10-18 |
| 1699316190 | Boise Plastic Surgery Boise Hand Center Pllc | Clinic/Center | 1070 N Curtis Rd Ste 135, Boise, ID 83706-1257 | 2019-10-05 |
| 1841780475 | Always A Way, LLC | Clinic/Center | 921 S Orchard St Ste 103, Boise, ID 83705 | 2018-05-18 |
| 1205345402 | Edge Medical Services Inc. | Clinic/Center | 2100 W Panama St, Boise, ID 83705-5120 | 2017-09-20 |
| 1811329592 | Family Care Clinic, LLC | Clinic/Center | 8050 W Rifleman St Ste 100, Boise, ID 83704-9006 | 2013-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1346799483 | Healing Sanctuary LLC | Clinic/Center | 187 E 13th St, Idaho Falls, ID 83404-5305 | 2016-09-30 |
| 1760741334 | Saint Alphonsus Regional Medical Center Inc | Clinic/Center | 131 Constitution Way, Nampa, ID 83686 | 2012-05-16 |
| 1750681607 | Family Services, Pllc | Clinic/Center | 501 N 16th St Ste 108, Payette, ID 83661-2782 | 2010-10-26 |
| 1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
| 1659371870 | Saint Alphonsus Medical Center Nampa, Inc. | Clinic/Center | 4300 E Flamingo Ave, Nampa, ID 83687-3138 | 2005-07-29 |
| 1881200517 | Vannvei LLC | Clinic/Center | 1522 17th St, Lewiston, ID 83501-3652 | 2020-09-18 |
| 1831716182 | Regenesis Health Centre Inc. | Clinic/Center | 430 W Iowa Ave Ste A, Nampa, ID 83686-2826 | 2020-07-02 |
| 1407335367 | Beacon Cancer Care Pllc | Clinic/Center | 980 W Ironwood Dr Ste 207, Coeur D Alene, ID 83814 | 2018-08-11 |
| 1184135337 | Valley Family Health Care, Inc | Clinic/Center | 1441 Ne 10th Ave, Payette, ID 83661-5420 | 2017-10-16 |
| 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.