BOISE VAMC (NPI# 1003223165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003223165 |
| Entity Type | Organization |
| Organization Name | BOISE VAMC |
| Other Organization Name | MOUNTAIN HOME VA CLINIC |
| Practice Address |
815 N 6th E Mountain Home ID 83647-2207 |
| Mailing Address |
Po Box 94402 Cleveland OH 44101-4402 |
| Practice Telephone | 7023413164 |
| Mailing Telephone | 7023413164 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2017-10-31 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MOUNTAIN HOME VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750798815 | Boise Vamc | Clinic/Center | 705 Lena St, Salmon, ID 83467-4208 | 2014-07-21 |
| 1548677602 | Boise Vamc | Clinic/Center | 635 Highway 20 N Ste 4, Hines, OR 97738-9462 | 2014-07-21 |
| 1164461042 | Boise Vamc | Clinic/Center | 260 2nd Ave E, Suite 12, Twin Falls, ID 83301-6242 | 2006-06-06 |
| 1124152921 | Boise Vamc | Clinic/Center | 4521 Thomas Jefferson St, Caldwell, ID 83605-5100 | 2007-03-15 |
| 1861441867 | Boise Vamc | General Acute Care Hospital | 500 W Fort St, Boise, ID 83702-4501 | 2006-05-08 |
| 1841258985 | Boise Vamc | Department of Veterans Affairs (VA) Pharmacy | 500 W Fort St, Boise, ID 83702-4501 | 2006-05-01 |
| Street Address |
815 N 6TH E |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647-2207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144335886 | Dental Center P.l.l.c. | Dentist | 815 N 6th E, Mountain Home, ID 83647-2207 | 2006-08-21 |
| 1679191241 | Randi Ortega | Licensed Practical Nurse | 815 N 6th E, Mountain Home, ID 83647-2207 | 2020-07-10 |
| 1174149264 | Anna Marie Garvin | Registered Nurse | 815 N 6th E, Mountain Home, ID 83647-2207 | 2020-06-24 |
| 1710191838 | Gail Brent Adams | Dentist | 815 N 6th E, Mountain Home, ID 83647-2207 | 2007-05-09 |
| 1114131315 | Kenneth Troy Stevens | Dentist | 815 N 6th E, Mountain Home, ID 83647-2207 | 2007-05-09 |
| 1851503056 | Robert Terry Hall | Dentist | 815 N 6th E, Mountain Home, ID 83647-2207 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| Find all providers in zip 83647 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063450617 | Little Rock Vamc | Clinic/Center | 759 Highway 62 E, Suite 331, Mountain Home, AR 72653-3260 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750798815 | Boise Vamc | Clinic/Center | 705 Lena St, Salmon, ID 83467-4208 | 2014-07-21 |
| 1609044478 | Spokane Vamc | Clinic/Center | 915 W Emma Ave, Coeur D Alene, ID 83814-2531 | 2008-02-14 |
| 1164461042 | Boise Vamc | Clinic/Center | 260 2nd Ave E, Suite 12, Twin Falls, ID 83301-6242 | 2006-06-06 |
| 1184262487 | We Care Wellness Center, Inc. | Clinic/Center | 827 W Prairie Ave, Hayden, ID 83835-8459 | 2019-12-17 |
| 1578007183 | Department of Veterans Affairs | Clinic/Center | 915 W Emma Ave, Coeur D Alene, ID 83814-2531 | 2016-12-16 |
| 1316338486 | Spokane Vamc | Clinic/Center | 30410 Highway 200, Ponderay, ID 83852-9601 | 2015-02-11 |
| 1093106171 | Walla Walla Vamc | Clinic/Center | 711 W North St, Grangeville, ID 83530-1349 | 2015-02-11 |
| 1497146823 | Salt Lake City Vamc | Clinic/Center | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2015-02-06 |
| 1114289618 | Rhonda Lynn Dutcher-barfuss | Clinic/Center | 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 | 2012-06-11 |
| 1124152921 | Boise Vamc | Clinic/Center | 4521 Thomas Jefferson St, Caldwell, ID 83605-5100 | 2007-03-15 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
Please comment or provide details below to improve the information on BOISE VAMC.
| 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.