THE FAMILY MEDICINE RESIDENCY OF IDAHO, INC. (NPI# 1841490075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841490075 |
| Entity Type | Organization |
| Organization Name | THE FAMILY MEDICINE RESIDENCY OF IDAHO, INC. |
| Other Organization Name | FAMILY MEDICINE HEALTH CENTER |
| Practice Address |
777 N Raymond St Boise ID 83704 |
| Mailing Address |
777 N Raymond St Boise ID 83704-9251 |
| Practice Telephone | 2085142500 |
| Practice Fax Number | 2083752217 |
| Mailing Telephone | 2085142500 |
| Mailing Fax Number | 2083752217 |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2020-09-28 |
| Authorized Official Name | TED D EPPERLY (PRESIDENT AND CEO) |
| Authorized Official Telephone | 2089548744 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 87843300 | 05 | |
| ID | 1841490075 | 05 | |
| ID | 807782300 | 05 |
| Other Name | Type Code |
|---|---|
| Family Medicine Health Center | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 121 E Fort St, Boise, ID 837126322 | 2085142525 | 2083752217 |
| 215 E Hawaii Ave, Nampa, ID 836866011 | 2085142502 | 2083752217 |
| 215 E Hawaii Ave, Nampa, ID 836866011 | 2085142529 | 2083752217 |
| 215 E Hawaii Ave # 260, Nampa, ID 836866011 | 2085142529 | 2083752217 |
| 215 E Hawaii Ave # 390, Nampa, ID 836866011 | 2085142502 | 2083752217 |
| 2275 S Eagle Rd Ste 120, Meridian, ID 836422620 | 2085142520 | 2083752217 |
| 3031 W Main St, Boise, ID 837022048 | 2085142500 | 2083752217 |
| 325 W Idaho St, Boise, ID 837026040 | 2085142525 | 2083752217 |
| 3277 E Louise Dr Ste 220, Meridian, ID 836429390 | 2085142509 | 2083752217 |
| 6565 W Emerald St, Boise, ID 837048737 | 2085142510 | 2083752217 |
| 708 E Wythe Creek Ct Ste 103, Kuna, ID 836345005 | 2089225130 | 2083752217 |
| 925 Nw 1st St, Meridian, ID 836422274 | 2085142527 | 2083752217 |
| 925 W 1st St, Meridian, ID 836422274 | 2085142527 | 2083752217 |
| 9850 W St Lukes Dr # 329, Nampa, ID 836877912 | 2085142509 | 2083752217 |
| 9850 W St Lukes Dr Ste 329, Nampa, ID 836877912 | 2085142509 | 2083752217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710525829 | The Family Medicine Residency of Idaho, Inc. | Pharmacy | 2275 S Eagle Rd Ste 120, Meridian, ID 83642-2620 | 2019-12-19 |
| Street Address |
777 N RAYMOND ST |
| City | BOISE |
| State | ID |
| Zip Code | 83704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566253 | Jeffrey Karl Edwards | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2005-05-24 |
| 1619599347 | Kim Mcgrath | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1437771169 | Kevin Mcnamee | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1003438730 | Tracy Adams | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1093337727 | Angela Bangs | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1902428634 | Amanda Aman | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1275155905 | Paige Ely | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1457973182 | Zara Bowden | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1992327621 | Kelsey Harding | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1366064099 | Jeffrey Chase | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1952756884 | Community Health Clinics, Inc. | Clinic/Center | 848 S La Cassia Dr, Boise, ID 83705-2253 | 2016-04-28 |
| 1508333246 | Community Health Clinics, Inc. | Clinic/Center | 2200 W Fairview Ave, Boise, ID 83702-6808 | 2018-10-31 |
| 1073001699 | Community Health Clinic Inc. | Clinic/Center | 301 N 29th St, Boise, ID 83702-4625 | 2018-04-30 |
| 1588678361 | Community Health Clinics Inc | Clinic/Center | 300 S 23rd St, Boise, ID 83702-4901 | 2006-07-28 |
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| 1013547801 | Health West, Inc. | Clinic/Center | 1001 N 7th Ave Ste 135, Pocatello, ID 83201-5761 | 2020-01-21 |
| 1861046039 | Health West, Inc. | Clinic/Center | 17400 N Hiline Rd, Pocatello, ID 83202-1669 | 2019-07-26 |
| 1518519255 | Health West Inc. | Clinic/Center | 911 N Grant Ave, Pocatello, ID 83204-2847 | 2019-07-12 |
| 1043794001 | Community Health Clinics, Inc. | Clinic/Center | 506 Fletcher Dr, Nampa, ID 83686-8854 | 2018-09-17 |
| 1972082675 | Community Health Clinics, Inc. | Clinic/Center | 1670 N Linder Rd, Kuna, ID 83634-3032 | 2018-08-13 |
| 1841779667 | Community Health Clinics, Inc. | Clinic/Center | 610 N School Ave, Kuna, ID 83634-1807 | 2018-08-13 |
| 1225517055 | Community Health Clinics, Inc. | Clinic/Center | 4085 E Greenhurst Rd, Nampa, ID 83686-8657 | 2018-08-13 |
| 1982183687 | Community Health Clinics, Inc. | Clinic/Center | 301 S Happy Valley Rd, Nampa, ID 83687-8828 | 2018-08-13 |
| 1396249546 | Community Health Clinic Inc. | Clinic/Center | 521 Carrie Rex, Melba, ID 83641 | 2018-03-22 |
| 1912401381 | Community Health Clinic Inc. | Clinic/Center | 700 N Star Rd, Star, ID 83669-5417 | 2018-03-21 |
| Find all providers with the same taxonomy | ||||
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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.