MEMORIAL HOSPITAL - ER PHYSICIANS (NPI# 1720282866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720282866 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL - ER PHYSICIANS |
| Practice Address |
645 E 5th St Weiser ID 83672-2202 |
| Practice Telephone | 2085490370 |
| Practice Fax Number | 2084144267 |
| Mailing Telephone | 2085490370 |
| Mailing Fax Number | 2084144267 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2009-01-29 |
| Authorized Official Name | WADE JOHNSON (CEO) |
| Authorized Official Telephone | 2085494450 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
32 | ID | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD ER PHYSICIANS | 000010006739 | 01 |
| ID | 002850400 | 05 | |
| WA | 3032901 | 05 | |
| ID | BLUE CROSS GROUP | 8K396 | 01 |
| OR | 121244 | 05 |
| Street Address |
645 E 5TH ST |
| City | WEISER |
| State | ID |
| Zip Code | 83672-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740353432 | Evan W. Lee Jr. | Emergency Medicine | 645 E 5th St, Weiser, ID 83672-2202 | 2006-11-17 |
| 1265903983 | Andrea Wheeler | Nurse Practitioner | 645 E 5th St, Weiser, ID 83672-2202 | 2018-12-06 |
| 1932650561 | Weiser Memorial Surgical Clinic | Specialist | 645 E 5th St, Weiser, ID 83672-2202 | 2016-10-19 |
| 1326475617 | Janice Elaine Grimaldo | Speech-Language Pathologist | 645 E 5th St, Weiser, ID 83672-2202 | 2013-10-01 |
| 1801095492 | Memorial Hospital | Nurse Practitioner | 645 E 5th St, Weiser, ID 83672-2202 | 2007-07-13 |
| 1902003858 | Memorial Hospital | General Acute Care Hospital | 645 E 5th St, Weiser, ID 83672-2202 | 2007-07-02 |
| 1639373772 | Memorial Hospital - Radiology | General Acute Care Hospital | 645 E 5th St, Weiser, ID 83672-2202 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891176798 | Christine Cooper | Nurse Practitioner | 35 W Idaho St, Weiser, ID 83672 | 2015-06-16 |
| 1356630941 | Jordan V Blanchard | Family Medicine | 360 E. Liberty, Weiser, ID 83672 | 2011-04-04 |
| 1427038231 | Christopher Earl Malloy | Dentist | 1067 Hwy 95, Weiser, ID 83672 | 2006-01-18 |
| 1457508418 | Christy Earlean Marvin | Home Health Aide | 1111 E Main St, Weiser, ID 83672 | 2008-08-21 |
| 1255364030 | Weiser Valley Hospital District | Orthopaedic Surgery | 645 E. 5th St., Weiser, ID 83672 | 2006-07-07 |
| 1568685543 | Weiser School District #431 | Specialist | 925 Pioneer Rd, Weiser, ID 83672-1146 | 2007-04-10 |
| 1275147712 | Madison Caldwell | Counselor | 925 Pioneer Rd, Weiser, ID 83672-1146 | 2020-09-02 |
| 1588108872 | Laura Haun | Specialist/Technologist | 275 Mcginnis Dr, Weiser, ID 83672-1262 | 2016-12-06 |
| 1073537486 | Bi-mart Corporation | Durable Medical Equipment & Medical Supplies | 1545 E 6th St, Weiser, ID 83672-1495 | 2006-07-27 |
| 1164047635 | Bridget Moore | Pharmacy Technician | 1545 E 6th St, Weiser, ID 83672-1495 | 2020-06-10 |
| Find all providers in zip 83672 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720298102 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th Street, Weiser, ID 83672-2202 | 2007-05-23 |
| 1881641629 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th St., Weiser, ID 83672-2202 | 2006-05-27 |
| 1902003858 | Memorial Hospital | General Acute Care Hospital | 645 E 5th St, Weiser, ID 83672-2202 | 2007-07-02 |
| 1639373772 | Memorial Hospital - Radiology | General Acute Care Hospital | 645 E 5th St, Weiser, ID 83672-2202 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851761464 | Brent Leavitt | General Acute Care Hospital | 4928 Pleasant View Dr, Chubbuck, ID 83202-1640 | 2015-09-25 |
| 1053669598 | Teton Valley Health Care, Inc | General Acute Care Hospital | 120 E Howard Avenue, Driggs, ID 83422-5112 | 2012-08-15 |
| 1639406267 | Florence Hospital, LLC | General Acute Care Hospital | 1300 E State St, Suite 102, Eagle, ID 83616-7059 | 2009-11-03 |
| 1912132176 | Initiatives Healthcare, LLC | General Acute Care Hospital | 1205 N 11th St, Boise, ID 83702-4102 | 2009-05-18 |
| 1417122821 | Elmore Medical Center Specialty Physician Group | General Acute Care Hospital | 890 N 6th E, Mountain Home, ID 83647-2206 | 2008-04-25 |
| 1275703241 | North Canyon Medical Center, Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
| 1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
| 1295769537 | Gooding County Hospital District | General Acute Care Hospital | 1120 Montana St, Gooding, ID 83330-1858 | 2006-07-11 |
| 1609826270 | Oneida County Hospital | General Acute Care Hospital | 150 N 200 W, Malad, ID 83252-1239 | 2006-05-12 |
| 1710959184 | Teton Valley Hospital & Surgicenter | General Acute Care Hospital | 120 East Howard Avenue, Driggs, ID 83422-5112 | 2006-02-01 |
| Find all providers with the same taxonomy | ||||
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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.