GLEN R ALBERTSON JR. (NPI# 1952462681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952462681 |
Entity Type | Individual |
Full Name | GLEN R ALBERTSON JR. |
Credential | M.D |
Practice Address |
1120 Montana St Gooding ID 83330-1858 |
Mailing Address |
1120 Montana St Po Box 481 Gooding ID 83330-1858 |
Practice Telephone | 2089344433 |
Practice Fax Number | 2089348643 |
Mailing Telephone | 2089344433 |
Mailing Fax Number | 2089348643 |
Enumeration Date | 2006-12-13 |
Last Update Date | 2007-07-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
282NC0060X | ID | Hospitals |
Street Address |
1120 MONTANA ST |
City | GOODING |
State | ID |
Zip Code | 83330-1858 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295769537 | Gooding County Hospital District | General Acute Care Hospital | 1120 Montana St, Gooding, ID 83330-1858 | 2006-07-11 |
1033329206 | David Circuit Christiansen | Physical Therapist | 1120 Montana St, Gooding, ID 83330-1858 | 2007-05-23 |
1427196526 | Charles Hancock | Counselor | 1120 Montana St, Gooding, ID 83330-1858 | 2007-02-01 |
1740341114 | Gooding County Hospital District | Medicare Defined Swing Bed Unit | 1120 Montana St, Gooding, ID 83330-1858 | 2006-12-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
1083959332 | Lydia Jo Missal | Counselor | 1832 E. 1750 S., Gooding, ID 83330 | 2012-11-27 |
1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
Find all providers in zip 83330 |
Taxonomy Code | 282NC0060X |
Grouping | Hospitals |
Classification | General Acute Care Hospital |
Specialization | Critical Access |
Definition to come. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275703241 | North Canyon Medical Center, Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
1295769537 | Gooding County Hospital District | General Acute Care Hospital | 1120 Montana St, Gooding, ID 83330-1858 | 2006-07-11 |
1609046671 | North Canyon Medical Center Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851761464 | Brent Leavitt | General Acute Care Hospital | 4928 Pleasant View Dr, Chubbuck, ID 83202-1640 | 2015-09-25 |
1053669598 | Teton Valley Health Care, Inc | General Acute Care Hospital | 120 E Howard Avenue, Driggs, ID 83422-5112 | 2012-08-15 |
1639406267 | Florence Hospital, LLC | General Acute Care Hospital | 1300 E State St, Suite 102, Eagle, ID 83616-7059 | 2009-11-03 |
1912132176 | Initiatives Healthcare, LLC | General Acute Care Hospital | 1205 N 11th St, Boise, ID 83702-4102 | 2009-05-18 |
1417122821 | Elmore Medical Center Specialty Physician Group | General Acute Care Hospital | 890 N 6th E, Mountain Home, ID 83647-2206 | 2008-04-25 |
1720298102 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th Street, Weiser, ID 83672-2202 | 2007-05-23 |
1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
1881641629 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th St., Weiser, ID 83672-2202 | 2006-05-27 |
1609826270 | Oneida County Hospital | General Acute Care Hospital | 150 N 200 W, Malad, ID 83252-1239 | 2006-05-12 |
1710959184 | Teton Valley Hospital & Surgicenter | General Acute Care Hospital | 120 East Howard Avenue, Driggs, ID 83422-5112 | 2006-02-01 |
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.