MR. MATTHEW FRANK IVIE (NPI# 1003325937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003325937 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW FRANK IVIE |
| Credential | PA-C |
| Practice Address |
267 N Canyon Dr Gooding ID 83330-5500 |
| Mailing Address |
940 E 1400 N Shelley ID 83274-5143 |
| Practice Telephone | 2089344433 |
| Mailing Telephone | 2082069631 |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2017-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
267 N CANYON DR |
| City | GOODING |
| State | ID |
| Zip Code | 83330-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053316786 | Guy Eric Grooms | Specialist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2005-06-17 |
| 1841800943 | Charles Bryan Simpson | Emergency Medical Technician, Paramedic | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2020-08-04 |
| 1619469525 | North Canyon Medical Center, Inc. | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-06-06 |
| 1871098137 | Amanda Paige Braga | Social Worker | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-28 |
| 1497259378 | Francisca O Mendez | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-23 |
| 1740783125 | Susan A. Ormond | Dietitian, Registered | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| 1538662895 | Mercedes Diaz | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| 1255834685 | Rosa Yuriko Saucedo | Nurse's Aide | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1235632662 | Anali Santos | Nurse's Aide | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1083117402 | Tammy Jo Dayley | Technician/Technologist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1083959332 | Lydia Jo Missal | Counselor | 1832 E. 1750 S., Gooding, ID 83330 | 2012-11-27 |
| 1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
| 1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
| 1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
| 1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
| 1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
| 1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| Find all providers in zip 83330 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831526854 | Associates In Family Practice | Physician Assistant | 425 Idaho St, Gooding, ID 83330-1258 | 2013-10-04 |
| 1184932584 | North Canyon Medical Center, Inc | Physician Assistant | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2010-09-20 |
| 1700841277 | Robert H Anderson | Physician Assistant | 425 Idaho Street, Gooding, ID 83330 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217911 | David Jeffrey Hanson | Physician Assistant | 740 Mckinley Ave Ste 100, Kellogg, ID 83837-2693 | 2019-10-18 |
| 1871060681 | Travis Henman | Physician Assistant | 1404 Pomerelle Ave Ste 150, Burley, ID 83318-2012 | 2018-10-30 |
| 1952889685 | Cody Mattingly | Physician Assistant | 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 | 2018-08-03 |
| 1992174072 | Alexa Rhea | Physician Assistant | 2841 Juniper Dr Ste 2, Lewiston, ID 83501-4719 | 2015-09-18 |
| 1043689441 | Derek R Wynn | Physician Assistant | 607 W Main Street, Grangeville, ID 83530 | 2015-09-16 |
| 1407223274 | Michael Kenneth Wucinich | Physician Assistant | 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 | 2015-08-28 |
| 1811364177 | Ashley Laren Popadics | Physician Assistant | 1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 | 2015-08-21 |
| 1073915963 | Jessica Bishop | Physician Assistant | 1499 W Hays St, Boise, ID 83702-5029 | 2014-09-23 |
| 1447652813 | Jessea Camille Whitlow | Physician Assistant | 2392 Addison Ave E, Twin Falls, ID 83301-6745 | 2014-09-17 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
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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.