KRISTI MATHISTAD (NPI# 1568739548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568739548 |
| Entity Type | Individual |
| Full Name | KRISTI MATHISTAD |
| Credential | CADC |
| Practice Address |
1115 B Street Plummer ID 83851 |
| Mailing Address |
1115 B Street Po Box 388 Plummer ID 83851 |
| Practice Telephone | 2086861931 |
| Practice Fax Number | 2086865813 |
| Mailing Telephone | 2086861931 |
| Mailing Fax Number | 2086865813 |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2011-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
1115 B STREET |
| City | PLUMMER |
| State | ID |
| Zip Code | 83851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437145554 | Paul R Grady | Dentist | 1115 B Street, Plummer, ID 83851-0388 | 2005-09-23 |
| 1528326519 | Lovinia Alexander | Counselor | 1115 B Street, Plummer, ID 83851-0388 | 2012-04-26 |
| 1881900900 | Providence Health & Services - Washington | Internal Medicine | 1115 B Street, Plummer, ID 83851-0000 | 2010-08-26 |
| 1366637068 | Benewah Medical Center | Clinic/Center | 1115 B Street, Plummer, ID 83851-0388 | 2007-09-06 |
| 1225244551 | Kimberley Dawn Legaspi | Dental Hygienist | 1115 B Street, Plummer, ID 83851-0388 | 2007-05-15 |
| 1760698013 | Sandra M Mcmichael | Counselor | 1115 B Street, Plummer, ID 83851-0388 | 2007-05-15 |
| 1871713198 | Carla Rae Patterson | Dietitian, Registered | 1115 B Street, Plummer, ID 83851 | 2007-04-27 |
| 1417010323 | James W Allen | Dentist | 1115 B Street, Benewah Medical Center, Plummer, ID 83851 | 2006-12-19 |
| 1558457721 | David J Ochoa | Radiologic Technologist | 1115 B Street, Benewah Medical Center, Plummer, ID 83851 | 2006-10-05 |
| 1306948674 | Benewah Medical Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1115 B Street, Plummer, ID 83851 | 2006-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326575325 | Terrin Loe | Dental Hygienist | 358-786 Long Road, Plummer, ID 83851 | 2017-05-22 |
| 1639542830 | Selene Bonnell-hall | Physical Therapy Assistant | 1100 A Street, Plummer, ID 83851 | 2015-11-10 |
| 1609245059 | Caley Jordan | Pharmacist | 427 N 12 St, Plummer, ID 83851 | 2015-09-16 |
| 1861741282 | Plummer Gateway Fire Protection | Ambulance | 609 Poleyard Rd, Plummer, ID 83851 | 2012-08-30 |
| 1497040349 | Jason Ford Chapman | General Practice | 427 N. 12th St., Plummer, ID 83851 | 2011-06-17 |
| 1861797060 | Tiffany Marie Korrer | Physical Therapy Assistant | 1100 A. Street, Plummer, ID 83851 | 2011-01-19 |
| 1710290234 | Brian Meyer | Optometrist | 427 Nth 12th St, Plummer, ID 83851 | 2010-07-26 |
| 1386884369 | James Smith | Clinical Medical Laboratory | 1115 E. St, Plummer, ID 83851 | 2009-03-03 |
| 1134378169 | Robert Samuel Davis | Physician Assistant | 427 N 12th St., Plummer, ID 83851 | 2008-09-15 |
| 1013192210 | Nikole J Mills | Nurse Practitioner | 427 N. 12th Street, Plummer, ID 83851 | 2008-01-07 |
| Find all providers in zip 83851 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225697212 | Tonya Marie Amour-patton | Counselor | 427 12th St, Plummer, ID 83851-4000 | 2019-06-12 |
| 1013447671 | Joshua Michael Severns | Counselor | 427 N 12th Street, Plummer, ID 83851 | 2017-06-15 |
| 1881082501 | Jamie Loftis | Counselor | 427 N. 12th St., Plummer, ID 83851-0388 | 2015-01-05 |
| 1952709198 | Carl Printz | Counselor | 427 N 12th St, Plummer, ID 83851-0388 | 2014-12-19 |
| 1528326519 | Lovinia Alexander | Counselor | 1115 B Street, Plummer, ID 83851-0388 | 2012-04-26 |
| 1013237189 | Jamie Dee Smith | Counselor | 427 12th St, Plummer, ID 83851-4000 | 2010-06-10 |
| 1760698013 | Sandra M Mcmichael | Counselor | 1115 B Street, Plummer, ID 83851-0388 | 2007-05-15 |
| 1770564635 | Connie Gene Miller | Counselor | 1115 B St, Plummer, ID 83851 | 2005-11-08 |
| 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 |
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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.