DR. RON WADE PORTER (NPI# 1770577728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770577728 |
| Entity Type | Individual |
| Full Name | DR. RON WADE PORTER |
| Credential | M.D. |
| Practice Address |
2375 Coronado St Idaho Falls ID 83404-7407 |
| Practice Telephone | 2085224600 |
| Practice Fax Number | 2085527521 |
| Mailing Telephone | 2085224600 |
| Mailing Fax Number | 2085527521 |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | M-7271 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD | 000010004000 | 01 |
| ID | BLUE CROSS | 42291 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528559903 | Ron Ray Porter | Counselor | 391 Cr 3750, Lampasas, TX 76550 | 2018-05-22 |
| 1952454639 | Ron L Porter | Occupational Therapist | 1100 9th Ave, Seattle, WA 98101-2756 | 2007-01-18 |
| Street Address |
2375 CORONADO ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780990 | Katie Jo Leask | Dietitian, Registered | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2019-09-24 |
| 1255621793 | Mitchael Conrad Steorts | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2011-04-18 |
| 1366560971 | Idaho Falls Pediatrics | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2007-03-26 |
| 1477608099 | Darin Leslie | Physician Assistant | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2007-01-24 |
| 1043204746 | Scott Alan Smith | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2005-09-08 |
| 1760476469 | Joseph Reed Moore | Pediatrics | 2375 Coronado St, Idaho Falls, ID 83404-7407 | 2005-09-08 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - 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 |
|---|---|---|---|---|
| 1669918769 | University of Utah Pediatric Services | Pediatrics | 1645 Pancheri Dr, Idaho Falls, ID 83402-3169 | 2017-01-12 |
| 1205940962 | Diane Rae Nielsen | Pediatrics | 3430 Washington Parkway, Idaho Falls, ID 83404 | 2006-08-19 |
| 1073528998 | Medical Center for Children & Adolescents, Pa | Pediatrics | 3430 Washington Pkwy, Idaho Falls, ID 83404-7579 | 2006-07-29 |
| 1063703312 | Jeffrey John Aughney | Pediatrics | 3430 Washington Pkwy, Idaho Falls, ID 83404-7579 | 2011-04-20 |
| 1154528727 | Joshua Michael Smith | Pediatrics | 3910 Washington Pkwy, Idaho Falls, ID 83404-7596 | 2007-06-28 |
| 1194935049 | Kelly Jarom Anderson | Pediatrics | 3430 Washington Pkwy, Idaho Falls, ID 83404-7579 | 2007-05-22 |
| 1487868311 | Aaron Howard Gardner | Pediatrics | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2007-05-10 |
| 1669595864 | Id Dept of Health & Welfare Cshp (hd6) | Pediatrics | 254 E St, Idaho Falls, ID 83402-3527 | 2007-04-10 |
| 1346362084 | Id Dept of Health & Welfare Cshp (hd7) | Pediatrics | 254 E St, Idaho Falls, ID 83402-3527 | 2007-04-04 |
| 1235243973 | Jill Denise Veber | Pediatrics | 3430 Washington Pkwy, Idaho Falls, ID 83404-7579 | 2006-08-19 |
| Find all providers in IDAHO FALLS | ||||
| 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.