TWO RIVERS MEDICAL GROUP (NPI# 1770044703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770044703 |
| Entity Type | Organization |
| Organization Name | TWO RIVERS MEDICAL GROUP |
| Practice Address |
151 W Galvani Dr Ste 151 Meridian ID 83642-8008 |
| Mailing Address |
Po Box 1311 Eagle ID 83616-1311 |
| Practice Telephone | 2082837691 |
| Mailing Telephone | 0882837691 |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | ERIN J PRETTYWEASEL (OWNER, CEO) |
| Authorized Official Telephone | 2082837691 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
151 W GALVANI DR STE 151 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-8008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457983462 | Amh Series II Id, LLC | Clinic/Center | 3875 E Overland Rd Ste 1e, Meridian, ID 83642-9005 | 2020-02-07 |
| 1275186835 | Bella Family Healthcare & Aesthetics | Clinic/Center | 1545 E Leighfield Dr Ste 100, Meridian, ID 83646-5371 | 2019-07-22 |
| 1821032376 | Saint Alphonsus Physician Services Inc | Clinic/Center | 3250 W Cherry Ln, Meridian, ID 83642-1120 | 2006-06-15 |
| 1891355392 | Kaylor Family Medicine Pllc | Clinic/Center | 2536 N Stokesberry Pl, Meridian, ID 83646-1144 | 2019-06-17 |
| 1457894339 | Mountain West Medical Services Pllc | Clinic/Center | 1067 S Wells St, Suite#110, Meridian, ID 83642-7997 | 2016-11-28 |
| 1841603768 | Treasure Valley Family Medicine, Pllc | Clinic/Center | 2428 N Stokesberry Pl, Meridian, ID 83646-5035 | 2014-06-09 |
| 1033424429 | Borron Family Medicine Pllc | Clinic/Center | 790 W Ustick Rd, Ste 110, Meridian, ID 83646-5558 | 2010-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1447801451 | Mountain Country Family Healthcare, Pllc | Clinic/Center | 31911 N 5th Ave, Spirit Lake, ID 83869 | 2019-09-23 |
| 1902387285 | Integrative Health Solutions Pllc | Clinic/Center | 1215 Michigan St Ste B, Sandpoint, ID 83864-5014 | 2018-08-24 |
| 1235618331 | Healthworks Med Group of Colorado P C | Clinic/Center | 126 E 21st St, Burley, ID 83318-2551 | 2018-08-09 |
| 1427537927 | Gem State Family Health Care Pllc | Clinic/Center | 496 Shoup Ave W Ste E, Twin Falls, ID 83301-5043 | 2018-08-07 |
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1073031118 | Clover Creek Medical | Clinic/Center | 175 North Main Street, Bloomington, ID 83223-8322 | 2017-09-08 |
| 1104351972 | Salmon River Clinic | Clinic/Center | 102 Courthouse Dr, Suite F, Salmon, ID 83467-3904 | 2017-04-28 |
| 1154877918 | Boise House Calls, LLC | Clinic/Center | 303 Elk Creek Road, Suite Box 88, Idaho City, ID 83631 | 2016-08-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on TWO RIVERS MEDICAL GROUP.
| 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.