Kyle S Hollenback (NPI# 1932574381, PAC ID# 9032491295) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1932574381 |
| PAC ID by PECOS | 9032491295 |
| Professional Enrollment ID | I20170123002828 |
| Full Name | Kyle S Hollenback |
| Organization Legal Name | GLENNS FERRY HEALTH CENTER INC |
| Address |
486 W 1st Ave Glenns Ferry ID 83623-2701 |
| Phone Number | 2083667416 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 5496656894 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130007 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER |
| 131311 | ST LUKE'S ELMORE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 486 W 1st Ave, Glenns Ferry, ID 83623-2701 | 2083667416 | GLENNS FERRY HEALTH CENTER INC |
| 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2085873988 | GLENNS FERRY HEALTH CENTER INC |
| Organization Legal Name | GLENNS FERRY HEALTH CENTER INC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia G Medrano | Nurse Practitioner | Glenns Ferry Health Center Inc | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 |
| Dawn D Best | Nurse Practitioner | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Katherine A Gray | Family Medicine | Glenns Ferry Health Center Inc | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 |
| Darin K Gere | Clinical Social Worker | Glenns Ferry Health Center Inc | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 |
| Mark R Ensminger | Family Medicine | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Mark E Merrell | Physician Assistant | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Ashley G Casto | Physician Assistant | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Saad Hijazi | Internal Medicine | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Jonathan G Casto | Physician Assistant | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Street Address |
486 W 1ST AVE |
| City | GLENNS FERRY |
| State | ID |
| Zip | 83623-2701 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dawn D Best | Nurse Practitioner | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Anson C Call | Physical Therapy | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 | |
| Mark R Ensminger | Family Medicine | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Mark E Merrell | Physician Assistant | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Ashley G Casto | Physician Assistant | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Saad Hijazi | Internal Medicine | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| Jonathan G Casto | Physician Assistant | Glenns Ferry Health Center Inc | 486 W 1st Ave, Glenns Ferry, ID 83623-2701 |
| City | GLENNS FERRY |
| Zip Code | 83623 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GLENNS FERRY + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Kyle S Hollenback.
| 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.