CENTER FOR COLORECTAL CARE, LLC (NPI# 1740319409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740319409 |
| Entity Type | Organization |
| Organization Name | CENTER FOR COLORECTAL CARE, LLC |
| Practice Address |
333 N 1st St Suite 130 Boise ID 83702-6100 |
| Practice Telephone | 7708231668 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES A OLSON (MANAGER) |
| Authorized Official Telephone | 7708231668 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | M9825 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
333 N 1ST ST SUITE 130 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935966 | Heidi Louise Nagel | Genetic Counselor, MS | 333 N 1st St, Suite 150, Boise, ID 83702-6100 | 2006-01-05 |
| 1558715235 | Laura Mae Defenbach | Genetic Counselor, MS | 333 N 1st St, Suite 150, Boise, ID 83702-6100 | 2016-04-19 |
| 1558799270 | Nita M Barrelier Verner | Nurse Practitioner | 333 N 1st St, Suite #140, Boise, ID 83702-6100 | 2013-10-15 |
| 1780949164 | Cortney Lynn Schnupp | Nurse Practitioner | 333 N 1st St, 240, Boise, ID 83702-6100 | 2012-07-11 |
| 1538476239 | Tyler S Stewart | Physician Assistant | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-09-02 |
| 1659699841 | St Luke's Regional Medical Center | Surgery | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-05-12 |
| 1366675985 | Sarah R. Sparks | Nurse Practitioner | 333 N 1st St, Suite 140, Boise, ID 83702-6100 | 2009-08-30 |
| 1730311564 | Aaron L Thomason | Nurse Practitioner | 333 N 1st St, Suite 280, Boise, ID 83702-6100 | 2009-08-12 |
| 1558508085 | Beau G Walker | Physician Assistant | 333 N 1st St, Suite 280, Boise, ID 83702-6100 | 2009-01-21 |
| 1295900744 | Jordan D Keyes | Spec/Tech, Cardiovascular | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2008-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982178596 | Huntington Laparoscopy, PC | Surgery | 222 N 2nd St Ste 107, Boise, ID 83702-6129 | 2019-01-16 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| 1326385410 | Robert Henry Morrell | Surgery | 2061 S Springbrook Ln, Boise, ID 83706 | 2013-01-09 |
| 1063774727 | Ciara Rosemary Huntington | Surgery | 222 North 2nd Street, Suite 107, Boise, ID 83702 | 2012-06-08 |
| 1306983689 | Elizabeth M Prier | Surgery | 900 N Liberty Street, Ste 101, Boise, ID 83704-8704 | 2007-01-30 |
| 1336290915 | Austin R Cushman | Surgery | 901 N Curtis Rd Ste 103, Boise, ID 83706-1339 | 2007-01-12 |
| 1013064641 | John M Livingston | Surgery | 8756 W Emerald St, Suite 136, Boise, ID 83704-4831 | 2007-01-04 |
| 1629188933 | Christian A. Hamlat | Surgery | 333 N 1st St. 1, Boise, ID 83702 | 2006-08-30 |
| 1730190836 | Matthew R Macha | Surgery | 166 W Jefferson St, Boise, ID 83702-6124 | 2006-08-11 |
| 1386612414 | Johnny Bert Green | Surgery | 1072 N Liberty Street, Suite 201, Boise, ID 83704 | 2006-03-14 |
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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.