Stephanie B Long (NPI# 1043448236, PAC ID# 7810145216) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1043448236 |
| PAC ID by PECOS | 7810145216 |
| Professional Enrollment ID | I20190528001209 |
| Full Name | Stephanie B Long |
| Organization Legal Name | THE FAMILY MEDICINE RESIDENCY OF IDAHO INC |
| Address |
777 N Raymond St Boise ID 83704-9251 |
| Phone Number | 2085142500 |
| Gender | F |
| Medical School | COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS |
| Graduation Year | 2009 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6709986797 |
| Number of Group Practice Members | 66 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130007 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 777 N Raymond St, Boise, ID 83704-9251 | 2085142500 | THE FAMILY MEDICINE RESIDENCY OF IDAHO INC |
| Organization Legal Name | THE FAMILY MEDICINE RESIDENCY OF IDAHO INC |
| Physicians | 64 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher S Link | Family Medicine | The Family Medicine Residency of Idaho Inc | 6565 W Emerald St, Boise, ID 83704-8737 |
| Molly Mccormick | Family Medicine | The Family Medicine Residency of Idaho Inc | 708 E Wythe Creek Ct, Suite 103, Kuna, ID 83634-5005 |
| Robert D Crouch | Family Medicine | The Family Medicine Residency of Idaho Inc | 325 W Idaho St, Boise, ID 83702-6040 |
| Heather E Nichols | Family Medicine | The Family Medicine Residency of Idaho Inc | 2275 S Eagle Rd, Suite 120, Meridian, ID 83642-2620 |
| Anastasia B Milliron | Nurse Practitioner | The Family Medicine Residency of Idaho Inc | 121 E Fort St, Family Medicine Residency of Idaho, Boise, ID 83712-6322 |
| Thomas C Ahlrichs | Clinical Social Worker | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Vincent J Serio Iii | Family Medicine | The Family Medicine Residency of Idaho Inc | 925 W 1st St, Meridian, ID 83642-2274 |
| Timothy M Deblieck | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Ted D Epperly | Family Medicine | The Family Medicine Residency of Idaho Inc | 6565 W Emerald St, Boise, ID 83704-8737 |
| Amanda M Berbert | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Street Address |
777 N RAYMOND ST |
| City | BOISE |
| State | ID |
| Zip | 83704-9251 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas C Ahlrichs | Clinical Social Worker | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Timothy M Deblieck | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Amanda M Berbert | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Kelsey E Ruszel | Registered Dietitian Or Nutrition Professional | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Justin A Glass | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| John D Williams | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Sandy Leigh Mudge | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Heather E Quinn | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Chelsea L Carlson | Family Medicine | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Susanne J Johnson | Clinical Social Worker | The Family Medicine Residency of Idaho Inc | 777 N Raymond St, Boise, ID 83704-9251 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tobin E Hill | Nurse Practitioner | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Adrian J Curnow | Pediatric Medicine | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Julia K Bouchard | Obstetrics/gynecology | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Steven J Fonken | Interventional Cardiology | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, Boise, ID 83704-0107 |
| Ellis J Salloum | Vascular Surgery | Saint Alphonsus Regional Medical Center Inc | 6140 W Curtisian Ave, Boise, ID 83704-0109 |
| Samantha J Benfield | Nurse Practitioner | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 102 Samg Cardiothoracic Services Boise, Boise, ID 83704-0109 |
| Calvin T Jewell | General Surgery | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 100 Samg General Surgery Suite 100, Boise, ID 83704-0109 |
| Noah Blue Edvalson | Chiropractic | 3224 N Maple Grove Rd, Boise, ID 83704-4214 | |
| Christopher A Waters | Clinical Psychologist | Living Hope Clinic Inc | 3308 N Cole Rd A, Boise, ID 83704-4407 |
| Charles M Rice | Psychologist, Clinical | 3308 N Cole Rd, Suite A, Boise, ID 83704-4407 | |
| Find all physicians in zip 83704 | |||
| City | BOISE |
| Zip Code | 83704 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | BOISE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Stephanie B Long.
| 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.