VISION QUEST MEDICAL CENTER, PA (NPI# 1568664506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568664506 |
| Entity Type | Organization |
| Organization Name | VISION QUEST MEDICAL CENTER, PA |
| Other Organization Name | SONNTAG EYE ASSOCIATES |
| Practice Address |
3025 W Cherry Ln Suite 207 Meridian ID 83642-1125 |
| Mailing Address |
5680 W Gage St Boise ID 83706-1326 |
| Practice Telephone | 2088981614 |
| Practice Fax Number | 2088981618 |
| Mailing Telephone | 2083773937 |
| Mailing Fax Number | 2083779455 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-05-21 |
| Authorized Official Name | JACOB ADAM MONG (PRESIDENT) |
| Authorized Official Telephone | 2083773937 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | ODP-100002 | ID | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | ODP-100417 | ID | Eye and Vision Services Providers |
| Y | 207W00000X | Ophthalmology | O-0860 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS GROUP NO | 46235 | 01 |
| ID | 807072300 | 05 | |
| ID | 000160500 | 05 | |
| ID | 807072200 | 05 | |
| ID | 001553800 | 05 | |
| ID | 806834700 | 05 |
| Other Name | Type Code |
|---|---|
| Sonntag Eye Associates | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2720 W Cherry Ln, Meridian, ID 836421137 | 2083773937 | 2083779455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790330637 | Vision Quest Medical Center, Pa | Ophthalmology | 8955 W Hackamore Dr, Boise, ID 83709-1673 | 2019-08-07 |
| 1497234306 | Vision Quest Medical Center, Pa | Ophthalmology | 1906 Fairview Ave Ste 100, Caldwell, ID 83605-5433 | 2018-08-10 |
| 1356542542 | Vision Quest Medical Center, Pa | Optometrist | 5680 W Gage St, Boise, ID 83706-1326 | 2007-05-29 |
| 1780641902 | Vision Quest Medical Center, Pa | Clinic/Center | 5680 W Gage St, Boise, ID 83706-1326 | 2006-05-01 |
| 1003873852 | Vision Quest Medical Center, Pa | Optometrist | 5680 W Gage St, Boise, ID 83706-1326 | 2006-04-26 |
| Street Address |
3025 W CHERRY LN SUITE 207 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-1125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649264003 | Donald K Stott | Internal Medicine | 3025 W Cherry Ln, Meridian, ID 83642-1125 | 2005-08-31 |
| 1710538251 | Jill Harris | Physical Therapist | 3025 W Cherry Ln, Meridian, ID 83642-8531 | 2019-09-25 |
| 1073053518 | Peter Larson | Nurse Practitioner | 3025 W Cherry Ln, Suite B, Meridian, ID 83642-8531 | 2017-03-02 |
| 1033669908 | Sarah Hayden | Physician Assistant | 3025 W Cherry Ln, Suite B, Meridian, ID 83642-8531 | 2016-10-04 |
| 1407303340 | Olivia Rochelle Mangeac | Physician Assistant | 3025 W Cherry Ln, Suite B, Meridian, ID 83642-8531 | 2016-09-08 |
| 1558741033 | Allyson Barton | Physical Therapist | 3025 W Cherry Ln, Meridian, ID 83642-8531 | 2015-06-01 |
| 1477747632 | Idaho Heart Care | Internal Medicine | 3025 W Cherry Ln, Suite 205, Meridian, ID 83642-8531 | 2007-08-30 |
| 1104045392 | Saint Alphonsus Regional Medical Center Inc | Clinic/Center | 3025 W Cherry Ln, Suite D, Meridian, ID 83642 | 2007-04-25 |
| 1619018926 | Diane M Hulbert | Advanced Practice Midwife | 3025 W Cherry Ln, Suite B, Meridian, ID 83642-1125 | 2007-02-09 |
| 1508877788 | Crystal L Jencks | Family Medicine | 3025 W Cherry Ln, Ste B, Meridian, ID 83642-8531 | 2006-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093071219 | Cassandra White | Ophthalmology | 2720 W Cherry Ln, Meridian, ID 83642-1137 | 2012-04-02 |
| 1588762223 | Jonathan Houston Moore | Ophthalmology | 2300 12th St, Meridian, MS 39301-3933 | 2006-09-20 |
| 1336251073 | Treasure Valley Eye Center P A | Ophthalmology | 3045 E St Lukes St # 100, Meridian, ID 83642-3507 | 2006-08-31 |
| 1083656334 | Scott C Simpson | Ophthalmology | 3715 E Overland Road, Suite 250, Meridian, ID 83642 | 2006-06-12 |
| 1548380835 | Meridian Ophthalmic Associates, P.a. | Ophthalmology | 2300 12th St, Meridian, MS 39301-3933 | 2007-03-30 |
| 1255456323 | Retina Consultants of Idaho, Pllc | Ophthalmology | 3715 E Overland Road, Suite 250, Meridian, ID 83642 | 2007-03-20 |
| 1336247089 | Perry Jay Goodman | Ophthalmology | 2300 12th St, Meridian, MS 39301-3933 | 2006-09-20 |
| 1356449078 | Thurman Keith Everett | Ophthalmology | 2300 12th St, Meridian, MS 39301-3933 | 2006-09-20 |
| 1568486884 | John Lawrence Mason Jr. | Ophthalmology | 1301 20th Ave, Meridian, MS 39301-4121 | 2006-07-27 |
| 1649294935 | Don E Marascalco | Ophthalmology | 1301 20th Ave, Meridian, MS 39301-4121 | 2006-07-27 |
| Find all providers in MERIDIAN | ||||
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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.