NOVA INTEGRATIVE HEALTH (NPI# 1912516303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912516303 |
| Entity Type | Organization |
| Organization Name | NOVA INTEGRATIVE HEALTH |
| Practice Address |
229 E Logan St Caldwell ID 83605-4835 |
| Practice Telephone | 2085045959 |
| Mailing Telephone | 2085045959 |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | JOHARY RODRIGUEZ (NURSE PRACTITIONER) |
| Authorized Official Telephone | 2085045959 |
| Authorized Official Credential | FNP, PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
229 E LOGAN ST |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-4835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240194 | Jarrod Vaughn Crump | Nurse Practitioner | 2609 S 10th Ave, Caldwell, ID 83605-6816 | 2020-06-25 |
| 1396379475 | Blake Mcdonald | Nurse Practitioner | 1906 Fairview Ave Ste 220, Caldwell, ID 83605-5432 | 2020-02-27 |
| 1669934774 | Jlyle Medical Clinic Pllc | Nurse Practitioner | 501 N Stone St, Caldwell, TX 77836-1134 | 2019-04-05 |
| 1316311954 | Ashley Croft | Nurse Practitioner | 2609 S 10th Ave, Caldwell, ID 83605-6816 | 2015-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245857952 | Lidia Timofeenko Petersen | Nurse Practitioner | 775 Wayne Ave, Pocatello, ID 83201-3718 | 2020-06-29 |
| 1790302594 | Dumu Psychiatry LLC | Nurse Practitioner | 9428 W Fairview Ave, Boise, ID 83704-8101 | 2020-06-29 |
| 1861024689 | Jessica Erin Bringman | Nurse Practitioner | 3624 23rd St, Lewiston, ID 83501-6121 | 2020-02-10 |
| 1528610532 | Shawn Warren | Nurse Practitioner | 755 Lomax St, Idaho Falls, ID 83401-2786 | 2019-07-10 |
| 1760950604 | Scott A Watkins | Nurse Practitioner | 2836 Cougar Ave, Nampa, ID 83687-9107 | 2018-11-08 |
| 1104309657 | Brigitta Panther | Nurse Practitioner | 418 W Reese St, Boise, ID 83706-6233 | 2018-09-11 |
| 1659870178 | Mark Mcgrath | Nurse Practitioner | 1309 Ponderosa Dr Ste 103, Sandpoint, ID 83864-8278 | 2018-02-10 |
| 1467855403 | Clint Emmett | Nurse Practitioner | 875 Perimeter Dr # Ms 3140, Moscow, ID 83844-2006 | 2014-10-06 |
| 1639507551 | Jason Martin | Nurse Practitioner | 13734 S 1st E, Idaho Falls, ID 83404-7852 | 2013-10-31 |
| 1881027241 | Colleen R Fleming | Nurse Practitioner | 2025 W Park Place, Ste B, Coeur D Alene, ID 83814-2785 | 2013-08-20 |
| 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.