PEDIATRIC SURGERY OF IDAHO (NPI# 1609997261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609997261 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SURGERY OF IDAHO |
| Practice Address |
100 E Idaho St Ste 300 Boise ID 83712-6269 |
| Practice Telephone | 2083455400 |
| Practice Fax Number | 2083455454 |
| Mailing Telephone | 2083455400 |
| Mailing Fax Number | 2083455454 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ADRIAN CURNOW (PRES) |
| Authorized Official Telephone | 2083455400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD GROUP # | 00010018063 | 01 |
| ID | BLUE CROSS GROUP # | 8C683 | 01 |
| Street Address |
100 E IDAHO ST STE 300 |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306995188 | Sarah L Hirsch | Surgery | 100 E Idaho St Ste 300, Boise, ID 83712-6269 | 2007-01-09 |
| 1023656667 | Julia R Kerr | Pharmacist | 100 E Idaho St Ste 300, Boise, ID 83712-6269 | 2019-12-13 |
| 1982242541 | Weiyi Li | Pharmacist | 100 E Idaho St Ste 300, Boise, ID 83712-6269 | 2019-12-13 |
| 1528587268 | Jacob Carlton Gere | Nurse Practitioner | 100 E Idaho St Ste 300, Boise, ID 83712-6269 | 2017-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689830820 | Christina G Biller | Surgery | 1072 N Liberty St Ste 200, Boise, ID 83704 | 2008-08-06 |
| 1306995188 | Sarah L Hirsch | Surgery | 100 E Idaho St Ste 300, Boise, ID 83712-6269 | 2007-01-09 |
| 1720204738 | St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery of Idaho | Surgery | 100 E Idaho St, Suite 300, Boise, ID 83712-6223 | 2007-04-18 |
| 1679622542 | Ellen M Reynolds | Surgery | 100 E Idaho St, Ste 300, Boise, ID 83712-6267 | 2007-01-09 |
| 1750430617 | Adrian J Curnow | Surgery | 1072 N Liberty Street, Ste 201, Boise, ID 83704-8708 | 2007-01-09 |
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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.