MRS. LEANNE M KOVICK (NPI# 1962804120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962804120 |
| Entity Type | Individual |
| Full Name | MRS. LEANNE M KOVICK |
| Credential | CFM |
| Practice Address |
2006 Blaine St Caldwell ID 83605-4343 |
| Practice Telephone | 2089855404 |
| Practice Fax Number | 2084025959 |
| Mailing Telephone | 2089855404 |
| Mailing Fax Number | 2084025959 |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2015-12-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224900000X | Mastectomy Fitter | CFM02746 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1962804120 | 05 |
| Street Address |
2006 BLAINE ST |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-4343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417398140 | Sara L Helmer | Social Worker | 2006 Blaine St, Caldwell, ID 83605-4343 | 2013-07-10 |
| 1710427513 | Lotus Counseling Services, LLC | Social Worker | 2006 Blaine St, Caldwell, ID 83605-4343 | 2017-02-28 |
| 1902202708 | A Beautiful You Mastectomy Boutique | Durable Medical Equipment & Medical Supplies | 2006 Blaine St, Caldwell, ID 83605-4343 | 2014-11-06 |
| 1558760611 | A Beautiful You Mastectomy Boutique | Prosthetic/Orthotic Supplier | 2006 Blaine St, Caldwell, ID 83605-4343 | 2014-08-14 |
| 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 | 224900000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Mastectomy Fitter |
| An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
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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.