UNIVERSITY PROFESSIONAL SERVICES (NPI# 1972757870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972757870 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PROFESSIONAL SERVICES |
| Other Organization Name | UNIVERSITY PROFESSIONAL SERVICES IN IDAHO |
| Practice Address |
3101 E State St Suite 2107 Eagle ID 83616-6232 |
| Mailing Address |
3181 Sw Sam Jackson Park Rd Mail Code Mbs Portland OR 97239-3011 |
| Practice Telephone | 2084733003 |
| Mailing Telephone | 5034948300 |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2016-12-12 |
| Authorized Official Name | ANTHONY R. MASCIOTRA (ASSOCIATE DEAN) |
| Authorized Official Telephone | 5034945099 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY PROFESSIONAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| University Professional Services in Idaho | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073054714 | University Professional Services | Durable Medical Equipment & Medical Supplies | 9317 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-03-14 |
| 1659605707 | University Professional Services | Clinic/Center | 2858 Eberlein Ave, Klamath Falls, OR 97603-4402 | 2009-09-22 |
| 1962656868 | University Professional Services | Ophthalmology | 600 Triangle Ctr., Suite 400, Longview, WA 98632-4667 | 2008-11-05 |
| 1932724762 | University Professional Services | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-06-08 |
| 1093252553 | University Professional Services | General Practice | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2017-01-23 |
| 1205385556 | University Professional Services | Internal Medicine | 2055 Nw Savier St, Suite 201, Portland, OR 97209-1770 | 2016-09-28 |
| 1750753687 | University Professional Services | Clinic/Center | 2214 Lloyd Center, Portland, OR 97232-1315 | 2015-10-30 |
| 1255722260 | University Professional Services | General Practice | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2015-02-12 |
| 1316354970 | University Professional Services | Clinic/Center | 621 Sw Alder St, Suite 520, Portland, OR 97205-3626 | 2014-07-16 |
| 1912259284 | University Professional Services | General Practice | 3181 Sw Sam Jackson Park Rd, Mailcode: Ppv 350, Portland, OR 97239-3011 | 2012-10-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | UNIVERSITY PROFESSIONAL SERVICES | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 |
| Street Address |
3101 E STATE ST SUITE 2107 |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-6232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194773598 | Kimberly R Tanabe | Internal Medicine | 3101 E State St, Suite 2120, Eagle, ID 83616-6232 | 2006-05-05 |
| 1801131800 | Katherine Hawkins Andrews | Physician Assistant | 3101 E State St, Ste 2120, Eagle, ID 83616-6232 | 2012-12-01 |
| 1457606832 | Jessica Ann Clark | Audiologist | 3101 E State St, Suite 2108, Eagle, ID 83616-6232 | 2012-07-20 |
| 1396970612 | Coleen D Hulbert | Family Medicine | 3101 E State St, Ste 1100, Eagle, ID 83616-6232 | 2009-05-18 |
| 1801057708 | Mary Ann Z. Huntington | Internal Medicine | 3101 E State St, Suite 2120, Eagle, ID 83616-6232 | 2008-06-23 |
| 1437198884 | Susanne L Stickler | Internal Medicine | 3101 E State St, Suite 2120, Eagle, ID 83616-6232 | 2006-06-04 |
| 1689627069 | John David Mcdermott | Physician Assistant | 3101 E State St, Suite 2120, Eagle, ID 83616 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518214345 | Diabetes Dynamics | Clinic/Center | 9 Rt. Ladybelle Pl, Box 5620, Eagle, CO 81631-5620 | 2012-08-10 |
| 1720188857 | Eagle Chiropractic PC | Clinic/Center | 5337 S State St, Eagle, ID 83616-4313 | 2006-09-25 |
| 1174170427 | Vail Clinic, Inc. | Clinic/Center | 377 Sylvan Lake Road, Eagle, CO 81631 | 2019-08-21 |
| 1700399359 | Caring Edge Op LLC | Clinic/Center | 77 N Fisher Park Way, Eagle, ID 83616 | 2017-11-06 |
| 1407129125 | Renu Medispa | Clinic/Center | 951 E Plaza Dr, Suite 150, Eagle, ID 83616-6566 | 2012-02-10 |
| 1760768428 | Healthy Alignment Chiropractic Pllc | Clinic/Center | 742 E State St Ste 150, Eagle, ID 83616-5941 | 2011-10-26 |
| 1336327923 | Gregory L. Flint M.d., P.C. | Clinic/Center | 868 E Riverside Dr, Suite 200, Eagle, ID 83616-6019 | 2008-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992323216 | Wolf Pack LLC | Clinic/Center | 939 S 25th E Ste 115, Ammon, ID 83406-5736 | 2020-07-13 |
| 1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
| 1164072187 | Peter John Leichtnam | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-12 |
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| 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.