PHATAMA PADAVANIJA (NPI# 1679527717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679527717 |
| Entity Type | Individual |
| Full Name | PHATAMA PADAVANIJA |
| Credential | MD |
| Practice Address |
725 Pole Line Rd W Twin Falls ID 83301-5800 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2088141600 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2014-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
17531 | AL | Allopathic & Osteopathic Physicians |
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
M-11228 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009998765 | 05 | |
| AL | 009997765 | 05 | |
| AL | 009997775 | 05 |
| Street Address |
725 POLE LINE RD W |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437150745 | Deborah Catherine Burr | Pharmacist | 725 Pole Line Rd W, Twin Falls, ID 83301-5860 | 2005-08-09 |
| 1386282770 | David Green | Pharmacist | 725 Pole Line Rd W, Twin Falls, ID 83301-5860 | 2019-12-16 |
| 1558720573 | Alisa Rawson | Dietitian, Registered | 725 Pole Line Rd W, Twin Falls, ID 83301-5860 | 2016-02-18 |
| 1518371699 | Nicole L Thomas | Social Worker | 725 Pole Line Rd W, Twin Falls, ID 83301-5800 | 2014-06-17 |
| 1821355330 | Jessica Thibault | Internal Medicine | 725 Pole Line Rd W, Twin Falls, ID 83301 | 2012-04-20 |
| 1326209701 | Jared R Manning | Internal Medicine | 725 Pole Line Rd W, Twin Falls, ID 83301-5800 | 2008-06-19 |
| 1851328504 | Carolyn S Doedyns | Nurse Practitioner | 725 Pole Line Rd W, Twin Falls, ID 83301-5860 | 2006-06-27 |
| 1548206584 | Timothy E Sawyer | Radiology | 725 Pole Line Rd W, Twin Falls, ID 83301-5800 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821355330 | Jessica Thibault | Internal Medicine | 725 Pole Line Rd W, Twin Falls, ID 83301 | 2012-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376567487 | Teresa Gray Hayes | Internal Medicine | 700 W Ironwood Dr Ste 130, Coeur D Alene, ID 83814-4404 | 2006-07-26 |
| 1215981832 | Gerardo Midence | Internal Medicine | 1250 Idaho Street, Lewiston, ID 83501 | 2006-05-19 |
| 1417214420 | Nathanael David Gay | Internal Medicine | 1440 E Mullan Ave, Post Falls, ID 83854 | 2012-04-15 |
| 1629095179 | St Alphonsus Professional Medical Services LLC | Internal Medicine | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2006-07-17 |
| 1265478325 | Karl Josef Schultheiss | Internal Medicine | 1055 N Curtis Rd, Boise, ID 83706 | 2006-06-20 |
| 1093753360 | Michael Rooney | Internal Medicine | 415 6th St, Lewiston, ID 83501-2431 | 2006-06-02 |
| 1083668248 | Sushma Pant | Internal Medicine | 1250 Idaho Street, Lewiston, ID 83501 | 2006-05-20 |
| 1821042029 | Katrina A Rolen | Internal Medicine | 1250 Idaho Street, Lewiston, ID 83501 | 2006-05-20 |
| City | TWIN FALLS |
| Zip Code | 83301 |
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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.