IDAHO NEUROLOGY PLLC (NPI# 1720423429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720423429 |
| Entity Type | Organization |
| Organization Name | IDAHO NEUROLOGY PLLC |
| Practice Address |
901 N Curtis Rd Suite 101 Boise ID 83706-1338 |
| Mailing Address |
2825 Fort Missoula Rd Ste 121 Missoula MT 59804-7403 |
| Practice Telephone | 2086085825 |
| Practice Fax Number | 2082873690 |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-06-05 |
| Authorized Official Name | THOMAS SWANSON (OWNER) |
| Authorized Official Telephone | 4062742295 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
M11896 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
901 N CURTIS RD SUITE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83706-1338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679569149 | Michael V Keiley | Allergy & Immunology | 901 N Curtis Rd, Ste 100, Boise, ID 83706-1394 | 2005-09-21 |
| 1952881336 | Nicholas Hayes | Physical Therapist | 901 N Curtis Rd, Boise, ID 83706-1338 | 2018-08-15 |
| 1245738038 | Kyla Megan Byers | Physician Assistant | 901 N Curtis Rd, Ste 501, Boise, ID 83706 | 2018-01-26 |
| 1932640968 | Shasta Marie Slavkovsky | Nurse Practitioner | 901 N Curtis Rd, #503, Boise, ID 83706-1338 | 2017-03-09 |
| 1750731667 | Taylor Lynne Norby | Physical Therapist | 901 N Curtis Rd, Suite 204, Boise, ID 83706-1338 | 2016-06-21 |
| 1073969564 | Milodie Mae Long | Speech-Language Pathologist | 901 N Curtis Rd, Ste. 204, Boise, ID 83706-1338 | 2016-05-13 |
| 1033583117 | Tyson Daniel Cook | Physical Therapist | 901 N Curtis Rd, Suite 204, Boise, ID 83706-1338 | 2015-11-30 |
| 1720461759 | Tawnya M Moeller | Specialist/Technologist, Other | 901 N Curtis Rd, Ste 304, Boise, ID 83706-1338 | 2015-07-08 |
| 1932582954 | Sarah L Aguirre-kuester | Specialist/Technologist, Other | 901 N Curtis Rd, Ste 304, Boise, ID 83706-1338 | 2015-07-08 |
| 1770985988 | Lindsey Marie Colter | Speech-Language Pathologist | 901 N Curtis Rd, Boise, ID 83706-1338 | 2014-09-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
| 1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
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| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386903359 | Daniel B Simmons | Psychiatry & Neurology | 1072 N Liberty St Ste 303, Boise, ID 83704 | 2012-05-11 |
| 1053678342 | Daniel Clark Abenroth | Psychiatry & Neurology | 9th Floor -- Neurosciences, 190 E Bannock St., Boise, ID 83712-8905 | 2012-04-12 |
| 1427294545 | Thomas E Henson | Psychiatry & Neurology | 3183 S Temperance Way, Boise, ID 83706-5703 | 2008-12-18 |
| 1235381948 | Karin Lindholm, D.o. | Psychiatry & Neurology | 901 N Curtis Rd Ste 403, Boise, ID 83706-1342 | 2008-10-14 |
| 1548452683 | Sergei V Kashirny | Psychiatry & Neurology | 125 E Idaho St Ste 300, Neurology, Boise, ID 83712-6256 | 2007-08-13 |
| 1982691598 | Richard W Wilson | Psychiatry & Neurology | 999 N Curtis Rd, Ste 506, Boise, ID 83706-1336 | 2005-09-29 |
| 1487640561 | James D Redshaw | Psychiatry & Neurology | 1072 N Liberty St, Suite 303, Boise, ID 83704-2800 | 2005-09-23 |
| 1093126229 | Colin Alan Lyness | Psychiatry & Neurology | 1072 N Liberty St, Ste 303, Boise, ID 83704 | 2014-05-09 |
| 1174934327 | Benjamin Murray Stewart | Psychiatry & Neurology | 1072 N Liberty St Ste 303, Boise, ID 83704 | 2014-05-09 |
| 1265855118 | Jeremy Handy, M.d., Pllc | Psychiatry & Neurology | 413 N Allumbaugh St, Suite 101, Boise, ID 83704-9212 | 2014-01-29 |
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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.