MRS. STACI DAWN ELLIS (NPI# 1639519044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639519044 |
Entity Type | Individual |
Full Name | MRS. STACI DAWN ELLIS |
Credential | LMT |
Practice Address |
1529 Belmont St Boise ID 83725-0001 |
Mailing Address |
3612 N Summercrest Pl Meridian ID 83646-7780 |
Practice Telephone | 2084261459 |
Mailing Telephone | 2083214701 |
Enumeration Date | 2013-06-29 |
Last Update Date | 2013-06-29 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | MASG-217 | ID | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376543884 | Staci Gaye Ellis | Physical Therapist | 7308 Bridgeport Way W Ste 103, Lakewood, WA 98499-8000 | 2005-07-26 |
Street Address |
1529 BELMONT ST |
City | BOISE |
State | ID |
Zip Code | 83725-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497040521 | Matt Niece | Counselor | 1529 Belmont St, Boise, ID 83725-1351 | 2011-06-16 |
1396398327 | Ericka Obaitek | Social Worker | 1529 Belmont St, Boise, ID 83706-8370 | 2019-07-18 |
1043871668 | Nathan Fauntleroy | Social Worker | 1529 Belmont St, Boise, ID 83706 | 2019-06-25 |
1750947701 | Monique Victoria Barber | Counselor | 1529 Belmont St, Boise, ID 83725-0001 | 2019-05-15 |
1336633247 | Natalie Anne Day | Social Worker | 1529 Belmont St, Boise, ID 83706 | 2018-06-15 |
1649793738 | Jessica Rae Kirwan | Counselor | 1529 Belmont St, Boise, ID 83706 | 2017-07-20 |
1215363353 | Maya Schimpf | Nurse Practitioner | 1529 Belmont St, Boise, ID 83725-1351 | 2013-09-20 |
1033551015 | Tanna Susan Willis | Massage Therapist | 1529 Belmont St, Boise, ID 83725-0001 | 2013-07-19 |
1265783419 | B Gary Bell | Clinic/Center | 1529 Belmont St, Boise, ID 83725-0001 | 2012-09-27 |
1588912661 | Natalie G Linhart | Counselor | 1529 Belmont St, Boise, ID 83725-0001 | 2012-08-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194276550 | Dylan E Schmick | Specialist/Technologist | 1910 University Drive, Boise, ID 83725 | 2016-10-20 |
1770183089 | Boise State University | Clinical Medical Laboratory | Bsu Science Bld Room 239 2133 W Cesar Chavez Ln, Boise, ID 83725-0001 | 2020-10-27 |
1386053213 | Keita Shimada | Specialist | 1910 University Dr # Ms 1020, Boise, ID 83725-0001 | 2014-08-05 |
1275815904 | Christian Gelok | Nurse Practitioner | 1910 University Dr # Ms 1351, Boise, ID 83725-0001 | 2011-09-20 |
1750680849 | Alison Radcliffe | Psychologist | 1529 S Belmont St, Boise, ID 83725-0001 | 2011-03-15 |
1336477207 | Rd Boardman | Psychologist | Health Services 1529 Belmont St, Boise, ID 83725-0001 | 2009-12-03 |
1194865444 | Boise State Health Center | Clinic/Center | 2103 University Dr, Boise, ID 83725-0001 | 2007-02-07 |
1033154802 | James Floyd Spooner | Specialist/Technologist | Boise State University, 1910 University Dr, Boise, ID 83725-0001 | 2006-06-17 |
1700359916 | Taylor Lannea Aylsworth-hayfield | Specialist/Technologist | 1910 University Dr, Boise, ID 83725-0001 | 2019-01-10 |
1275071110 | Savannah Knighton | Specialist/Technologist | 1910 University Dr, Boise, ID 83725-0001 | 2017-02-10 |
Find all providers in zip 83725 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851855803 | Lauren Rybarczyk | Specialist | 11498 W Carmichael Dr, Boise, ID 83709-7382 | 2019-01-24 |
1851834311 | Tegan Shuman | Specialist | 7307 W San Fernando Dr, Boise, ID 83704-5953 | 2016-11-30 |
1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
1093119042 | Robert Porter II | Specialist | 1346 E Candleridge Dr, Boise, ID 83712-6504 | 2014-10-20 |
1760885073 | Kelcee Keyes | Specialist | 1705 N Cole Rd, Boise, ID 83704-7304 | 2014-09-30 |
1386053213 | Keita Shimada | Specialist | 1910 University Dr # Ms 1020, Boise, ID 83725-0001 | 2014-08-05 |
1316373186 | Ralph V Nishitani | Specialist | 9317 W Pandion Ct, Boise, ID 83714-6715 | 2013-09-24 |
1548608094 | James Doyce Strong Jr. | Specialist | 3675 S Pimmit Ave, Boise, ID 83706-6416 | 2013-06-06 |
1649409269 | Iris Ginron Baker | Specialist | 3555 N Cole Rd, 105, Boise, ID 83704-0733 | 2009-07-02 |
1356589931 | Jay T. Ballhagen | Specialist | 10500 W Waterway Ct, Boise, ID 83714-3616 | 2009-02-04 |
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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.