ALLIANCE MEDICAL GROUP, LLC (NPI# 1770729063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770729063 |
| Entity Type | Organization |
| Organization Name | ALLIANCE MEDICAL GROUP, LLC |
| Other Organization Name | PRIMARY HEALTH MEDICAL GROUP |
| Practice Address |
3280 E. Lanark Drive Meridian ID 83642 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2083774400 |
| Practice Fax Number | 2083774416 |
| Mailing Telephone | 2089556500 |
| Mailing Fax Number | 2089556503 |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2019-02-13 |
| Authorized Official Name | DAVID PETERMAN (PRESIDENT) |
| Authorized Official Telephone | 2089556506 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primary Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1033534276 | Alliance Medical Group, LLC | Family Medicine | 1623 South Wells Avenue, Meridian, ID 83642 | 2014-02-25 |
| 1497991749 | Alliance Medical Group, LLC | Family Medicine | 1907 Broadway Ave, Suite 101, Boise, ID 83706-4201 | 2008-12-16 |
| 1568413920 | Alliance Medical Group, LLC | Family Medicine | 10482 W Carlton Bay Dr, Garden City, ID 83714-5143 | 2006-05-12 |
| 1124641188 | Alliance Medical Group, LLC | Family Medicine | 1475 N Cole Rd, Boise, ID 83704-8537 | 2020-05-26 |
| 1073079463 | Alliance Medical Group, LLC | Family Medicine | 512 N 21st Ave, Caldwell, ID 83605-4368 | 2019-02-11 |
| 1457868002 | Alliance Medical Group, LLC | Family Medicine | 1375 N Happy Valley Rd, Nampa, ID 83687-5280 | 2018-01-04 |
| 1386003770 | Alliance Medical Group, LLC | Family Medicine | 1900 W. Chinden Blvd., Meridian, ID 83646 | 2016-02-15 |
| 1871969246 | Alliance Medical Group, LLC | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2015-08-19 |
| Street Address |
3280 E. LANARK DRIVE |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841770674 | Olivia Holmes | Nurse Practitioner | 3280 E. Lanark Drive, Meridian, ID 83642 | 2018-08-21 |
| 1942713771 | Kristen Larkin | Nurse Practitioner | 3280 E. Lanark Drive, Meridian, ID 83642 | 2017-11-15 |
| 1912427279 | Jessica E Elkin | Physician Assistant | 3280 E. Lanark Drive, Meridian, ID 83642 | 2017-06-27 |
| 1780820076 | Alliance Medical Group, LLC | Family Medicine | 3280 E. Lanark Drive, Meridian, ID 83642 | 2008-12-17 |
| 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 | 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 |
|---|---|---|---|---|
| 1801216940 | Seth Branahl | Pediatrics | 520 S Eagle Rd Ste 2209, Meridian, ID 83642-6354 | 2014-04-16 |
| 1972872950 | John Dubard Mceachin | Pediatrics | 4820 Country Club Dr, Meridian, MS 39305-1839 | 2011-12-21 |
| 1841598273 | Anderson Physician Alliance, Inc. | Pediatrics | 2514 67th Avenue Loop Ste 112, Meridian, MS 39307-7260 | 2011-03-09 |
| 1033435896 | Lisa S Labor | Pediatrics | 1620 S. Celebration, Meridian, ID 83642 | 2010-04-19 |
| 1356504872 | Robert Ira Eubanks | Pediatrics | 1523 22nd Ave Ste B, Meridian, MS 39301-4016 | 2008-07-03 |
| 1154535375 | Mary Alice Schaefer | Pediatrics | 7961 Van Zyverden Rd, Meridian, MS 39305-9124 | 2007-05-09 |
| 1063557163 | Eastgate Peds Care | Pediatrics | 2203 Highway 39 N Ste B, Meridian, MS 39301-2609 | 2007-02-20 |
| 1477501880 | Elsa J. Lee | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-05-05 |
| 1356306740 | Kimberly D Ferguison | Pediatrics | 3277 E Louise Dr Ste 200, Meridian, ID 83642-9351 | 2006-04-19 |
| 1093797623 | Lara L. Ross | Pediatrics | 1500 Hwy 19 N, Meridian, MS 39307-5335 | 2005-11-18 |
| Find all providers in MERIDIAN | ||||
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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.