MARK A GRANRUD (NPI# 1043286222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043286222 |
| Entity Type | Individual |
| Full Name | MARK A GRANRUD |
| Credential | PA-C |
| Practice Address |
215 E Hawaii Avenue Nampa ID 83686 |
| Mailing Address |
217 W Georgia Suite 115 Nampa ID 83686 |
| Practice Telephone | 2084633000 |
| Practice Fax Number | 2084633034 |
| Mailing Telephone | 2084633000 |
| Mailing Fax Number | 2084633034 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA621 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
215 E HAWAII AVENUE |
| City | NAMPA |
| State | ID |
| Zip Code | 83686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083753248 | Wayne S Kenning | Specialist/Technologist, Other | 215 E Hawaii Avenue, Nampa, ID 83686 | 2007-02-05 |
| 1093877342 | Joni S Hunter | Specialist/Technologist, Other | 215 E Hawaii Avenue, Nampa, ID 83686 | 2006-12-14 |
| 1609943935 | Eric N Wells | Physician Assistant | 215 E Hawaii Avenue, Nampa, ID 83686 | 2006-11-30 |
| 1437166550 | Roy A Sternes | Physician Assistant | 215 E Hawaii Avenue, Nampa, ID 83186 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174096606 | Derek Scott Ahlstrom | Physician Assistant | 847 Parkcentre Way Ste 7, Nampa, ID 83651-1794 | 2019-01-08 |
| 1083197016 | Jocelyn Ashley Benton | Physician Assistant | 3908 E Flamingo Ave, Nampa, ID 83687-3102 | 2018-09-14 |
| 1376090985 | Stephen Michael Wren | Physician Assistant | 11035 W Karcher Rd, Nampa, ID 83651 | 2016-09-01 |
| 1952799009 | Leslie Arlene Lewis | Physician Assistant | 9850 St Lukes Dr Ste 215, Nampa, ID 83687-7912 | 2014-12-23 |
| 1598192676 | Louie Ward Beech | Physician Assistant | 1510 12th Ave, Ste 200, Nampa, ID 83686 | 2013-10-03 |
| 1629155809 | Kristin Lund Lewis | Physician Assistant | 9850 W St Lukes Dr Ste 129, Nampa, ID 83687-7912 | 2006-11-01 |
| 1174513188 | Thad W Wilkey | Physician Assistant | 16111 N Brinson St Ste100, Nampa, ID 83687-9203 | 2005-10-21 |
| 1669002721 | Nicole Webb | Physician Assistant | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-01-16 |
| 1407493638 | Alison R Dekerchove | Physician Assistant | 1115 12th Ave Rd, Nampa, ID 83686-5738 | 2019-12-06 |
| 1871136978 | Katelyn Elyse Macdonald | Physician Assistant | 11035 Karcher Rd, Nampa, ID 83651-8200 | 2019-10-21 |
| Find all providers in NAMPA | ||||
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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.