John M Wick (NPI# 1982657375, PAC ID# 2163402710) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is SPORTS MEDICINE.
| Nation Provider ID (NPI) | 1982657375 |
| PAC ID by PECOS | 2163402710 |
| Professional Enrollment ID | I20040723000202 |
| Full Name | John M Wick |
| Organization Legal Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Address |
703 S Americana Blvd Suite 150 Boise ID 83702-4976 |
| Phone Number | 2087066375 |
| Gender | M |
| Credential | MD |
| Medical School | OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | SPORTS MEDICINE |
| Group Practice PAC ID | 4981878402 |
| Number of Group Practice Members | 698 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 | 2087066375 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Organization Legal Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Physicians | 831 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Scholten | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Tracye J Lawyer | Orthopedic Surgery | St Lukes Clinic-treasure Valley LLC | 9850 St Lukes Dr, Suite 215, Nampa, ID 83687-7912 |
| Alex Mari Tanabe | Internal Medicine | St Lukes Clinic-treasure Valley LLC | 600 N Robbins Rd, Boise, ID 83702-4565 |
| Jessica J Carpenter | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 1620 S Kimball Ave, Caldwell, ID 83605-4547 |
| Whitney B Conrad | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 1226 W River St, Boise, ID 83702-7049 |
| Megan D Larson | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 287 W Jefferson St, Boise, ID 83702-6045 |
| Bonnie M Reed | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3090 E Gentry Way, Suite 200, Meridian, ID 83642-3550 |
| Scott J Chyna | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Sarah J Mooseau | Qualified Audiologist | St Lukes Clinic-treasure Valley LLC | 510 N 2nd St, Suite 201, Boise, ID 83702-6078 |
| Nitya Alluri | Hematology | St Lukes Clinic-treasure Valley LLC | 100 E Idaho St, Suite 302, Boise, ID 83712-6269 |
| Street Address |
703 S AMERICANA BLVD SUITE 150 |
| City | BOISE |
| State | ID |
| Zip | 83702-4976 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott J Chyna | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Michael Cabahug Pahang | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Trek D Lyons | Family Medicine | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Yvette L Jackson | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Thomas J Orthmeyer Jr. | Psychiatry | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Jennifer E Phillips | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Laura Musteti Oprea | Psychiatry | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Alison J Krause | Psychiatry | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Taylor J Rogers | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Boise, ID 83702-4976 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kim Kutzner | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
| Stacey L Scanlan | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
| Jody Alison Thatcher Bullard | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
| Ali Lubbers | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
| David A Teed | Clinical Social Worker | 1407 N 13th St, Boise, ID 83702-3531 | |
| Martha Ann Stacy | Psychologist, Clinical | 1718 W Jefferson St, Boise, ID 83702-3949 | |
| Renee Ours Bild | Clinical Social Worker | 1718 W Jefferson St, Boise, ID 83702-3949 | |
| Amber L Simonson | Optometry | Ada Vision Center Pa | 1926 W State St, Boise, ID 83702-3957 |
| Todd Anthony Noble | Optometry | Ada Vision Center Pa | 1926 W State St, Boise, ID 83702-3957 |
| Lauren M Huber | Optometry | Ada Vision Center Pa | 1926 W State St, Boise, ID 83702-3957 |
| Find all physicians in zip 83702 | |||
| City | BOISE |
| Zip Code | 83702 |
| Specialty | SPORTS MEDICINE |
| City + Specialty | BOISE + SPORTS MEDICINE |
Please comment or provide details below to improve the information on John M Wick.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.