DR. SHELLY HAUG (NPI# 1710277215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710277215 |
| Entity Type | Individual |
| Full Name | DR. SHELLY HAUG |
| Other Name | SHELLY HAUG GIVEN |
| Credential | M.D. |
| Practice Address |
3100 Channing Way Idaho Falls ID 83404 |
| Mailing Address |
11175 Campus Street Coleman Pavilion Suite 11121 Loma Linda CA 92354 |
| Practice Telephone | 2523676016 |
| Mailing Telephone | 9096515746 |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2018-08-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
M-14224 | ID | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3100 CHANNING WAY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851396519 | Jamie L Carter | Physician Assistant | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2005-06-17 |
| 1821697681 | Taylor Olivia Woodrow | Physician Assistant | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-10-22 |
| 1154944288 | Kristina Stickley | Dietitian, Registered | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-05-22 |
| 1487274932 | Bailey Elizabeth Kimbel | Registered Nurse | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-04-24 |
| 1952930109 | Chris Blaine | Student in an Organized Health Care Education/Training Program | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-04-08 |
| 1265061493 | Bradley Paul Roth | Student in an Organized Health Care Education/Training Program | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-04-08 |
| 1700415023 | Nicole Rosemin | Student in an Organized Health Care Education/Training Program | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-04-07 |
| 1639708027 | Victor Liu | Student in an Organized Health Care Education/Training Program | 3100 Channing Way, Idaho Falls, ID 83404 | 2020-04-07 |
| 1194354613 | Matthew James Baechle | Student in an Organized Health Care Education/Training Program | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-04-06 |
| 1639707961 | Dale Carlson Keller | Student in an Organized Health Care Education/Training Program | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2020-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114346749 | Jordan Simpson | Pediatrics | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2014-04-10 |
| 1790939056 | Neonatal Associates, Pllc | Pediatrics | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2008-11-12 |
| 1285786046 | Patients First Neonatology LLC | Pediatrics | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2007-01-18 |
| 1518995026 | Robert Wycliffe Cheatham IIi | Pediatrics | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2006-06-30 |
| 1023083680 | Shannon Jenkins | Pediatrics | 2860 Channing Way, Suite 100, Idaho Falls, ID 83404-7531 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144269747 | Stewart Lawrence | Pediatrics | 6030 W Emerald St, Boise, ID 83704-8855 | 2006-06-06 |
| 1619263563 | Timothy J Ulrich | Pediatrics | 801 Pole Line Rd W, Twin Falls, ID 83301-5810 | 2011-06-20 |
| 1316191976 | Brook Yuknis Lang | Pediatrics | 2003 Kootenai Health Way, Coeur D Alene, ID 83814 | 2008-11-10 |
| 1427222868 | Lisa Lynn Mcgill-vargas | Pediatrics | 2003 Kootenai Health Way, Coeur D Alene, ID 83814 | 2008-04-16 |
| 1780870360 | Nathan L Thornton | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2007-09-18 |
| 1083825509 | Maggie Chen | Pediatrics | 2003 Kootenai Health Way, Coeur D Alene, ID 83814 | 2007-05-25 |
| 1558495796 | James W Vanlooy | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2007-03-16 |
| 1619018470 | Kimberly Judd | Pediatrics | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-02-12 |
| 1598828378 | Erik N Meyers | Pediatrics | 190 E Bannock St, Boise, ID 83712-6241 | 2006-12-19 |
| 1790866044 | Kendra Mae Black-smith | Pediatrics | 2003 Kootenai Health Way, Coeur D Alene, ID 83814 | 2006-10-17 |
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| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.