IDAHO REGIONAL HAND & UPPER EXTREMITY CENTER PLLC (NPI# 1003157801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003157801 |
Entity Type | Organization |
Organization Name | IDAHO REGIONAL HAND & UPPER EXTREMITY CENTER PLLC |
Practice Address |
444 Hospital Way Ste 710 Pocatello ID 83201 |
Mailing Address |
444 Hospital Way Ste 710 Pocatello ID 83201-2745 |
Practice Telephone | 2082354263 |
Practice Fax Number | 2082334268 |
Mailing Telephone | 2082354263 |
Mailing Fax Number | 2082334268 |
Enumeration Date | 2013-03-05 |
Last Update Date | 2018-08-30 |
Authorized Official Name | DR. JEFFREY DEE STUCKI (PRESIDENT) |
Authorized Official Telephone | 2082354263 |
Authorized Official Credential | DO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
M-8547 | ID | Allopathic & Osteopathic Physicians |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-684 | ID | Physician Assistants & Advanced Practice Nursing Providers |
Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
O-0574 | ID | Allopathic & Osteopathic Physicians |
Street Address |
444 HOSPITAL WAY STE 710 |
City | POCATELLO |
State | ID |
Zip Code | 83201 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457345316 | Vermon S Esplin | Orthopaedic Surgery | 444 Hospital Way Ste 710, Pocatello, ID 83201-2745 | 2005-09-07 |
1962832923 | Dale Mckay Belnap | Physician Assistant | 444 Hospital Way Ste 710, Pocatello, ID 83201-2745 | 2013-11-12 |
1073877213 | Ryan Ned Miller | Orthopaedic Surgery | 444 Hospital Way Ste 710, Pocatello, ID 83201 | 2012-07-03 |
1083857536 | Jeffrey Dee Stucki | Orthopaedic Surgery | 444 Hospital Way Ste 710, Pocatello, ID 83201-2745 | 2009-04-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
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Taxonomy Code | 207XS0106X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Hand Surgery |
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730644808 | Jerald Walker | Orthopaedic Surgery | 1779 W Cedar Grove St, Meridian, ID 83646-3637 | 2019-02-04 |
1184020075 | Tim Thurman Md PC | Orthopaedic Surgery | 933 S Utah Ave, Idaho Falls, ID 83402-3322 | 2014-11-05 |
1275854630 | Louis Horst Poppler | Orthopaedic Surgery | 3399 E Louise Dr Ste 400, Meridian, ID 83642 | 2010-06-18 |
1023337631 | Patrick Cole | Orthopaedic Surgery | 1070 N Curtis Rd Ste 135, Boise, ID 83706-1257 | 2010-05-21 |
1932380912 | Intermountain Hand Clinic Pa | Orthopaedic Surgery | 914 N Curtis Rd, Boise, ID 83706-1308 | 2007-11-19 |
1144376195 | Alexander Orthopaedics, P.a. | Orthopaedic Surgery | 100 Hospital Dr., Ste 100, Ketchum, ID 83340-6997 | 2007-01-25 |
1669423539 | Tyler R Wayment | Orthopaedic Surgery | 738 N College Rd, Suite A, Twin Falls, ID 83301-3385 | 2006-05-15 |
1588659866 | Steven Randolph Boyea | Orthopaedic Surgery | 320 Warner Dr, Lewiston, ID 83501-4441 | 2005-09-13 |
1932693025 | Jeremy Toomey, Md Pllc | Orthopaedic Surgery | 7979 W Rifleman St, Boise, ID 83704-9066 | 2018-06-21 |
1851799621 | Orthopedic Specialty Institute, LLC | Orthopaedic Surgery | 1233 N Northwood Center Ct, Coeur D Alene, ID 83814-6190 | 2014-12-10 |
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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.