CLOVER CREEK MEDICAL (NPI# 1073031118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073031118 |
| Entity Type | Organization |
| Organization Name | CLOVER CREEK MEDICAL |
| Practice Address |
175 North Main Street Bloomington ID 83223-8322 |
| Mailing Address |
Po Box 208 Bloomington ID 83223-0208 |
| Practice Telephone | 8013620157 |
| Practice Fax Number | 8013620157 |
| Mailing Telephone | 8013620157 |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2017-09-08 |
| Authorized Official Name | BRITTANY STRONG (CEO) |
| Authorized Official Telephone | 8013620157 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
175 NORTH MAIN STREET |
| City | BLOOMINGTON |
| State | ID |
| Zip Code | 83223-8322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326942 | Shakur Abdisalam | Home Health | 1440 E Old Shakopee Rd, Bloomington, MN 55425-2438 | 2020-11-06 |
| 1023618956 | Empowerme Rehabilitation Illinois, LLC | Skilled Nursing Facility | 3203 E Moores Pike, Bloomington, IN 47401-7122 | 2020-10-29 |
| 1083214159 | Amber Kinney, LLC | Clinic/Center | 623 S Washington St Apt A, Bloomington, IN 47401-5645 | 2020-10-28 |
| 1275132003 | Faizo A Hersi | Student in an Organized Health Care Education/Training Program | 9700 International Dr Suite 300, Bloomington, MN 55425 | 2020-10-22 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1679171516 | Muna Shire | Behavior Technician | 9133 Knox Ave S, Bloomington, MN 55431-2213 | 2020-10-13 |
| 1710585997 | Bloomington Neurofeedback | Clinic/Center | 1905 S Liberty Dr, Bloomington, IN 47403-5146 | 2020-10-11 |
| 1669079398 | Ta-kisha Jones | Health Educator | 309 N. Woodlawn Ave, Bloomington, IN 47408 | 2020-10-06 |
| 1952918757 | Alayna Kaye Gray | Developmental Therapist | 3825 S Woods Edge Bnd, Bloomington, IN 47401-8436 | 2020-09-25 |
| 1235744533 | Integrity Counseling, Inc. | Clinic/Center | 502 S Morris Ave Unit D, Bloomington, IL 61701-4891 | 2020-09-13 |
| Find all providers in BLOOMINGTON | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1063489805 | Healthspot | Clinic/Center | 3064 E 3rd St, Bloomington, IN 47401-5425 | 2006-03-01 |
| 1427569367 | Wellness for Life | Clinic/Center | 524 N Fairview St, Bloomington, IN 47404-3774 | 2017-10-18 |
| 1811385925 | Activate Healthcare - Monroe Clinic | Clinic/Center | 119 W 7th St, Bloomington, IN 47404-3926 | 2014-12-26 |
| 1285060947 | Kellie Lyn Dunkin | Clinic/Center | 451 S Park Ridge Rd, Suite 101, Bloomington, IN 47401-8589 | 2013-09-25 |
| 1295005445 | Chestnut Health System, Inc | Clinic/Center | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2012-01-05 |
| 1669752960 | Immanuel Health Center | Clinic/Center | 502 S Morris Ave, Suite A, Bloomington, IL 61701-4884 | 2011-08-18 |
| 1174706816 | Central Illinois Pediatric Associates LLC | Clinic/Center | 2427 Maloney Dr, Bloomington, IL 61704-3750 | 2007-12-17 |
| 1265614242 | Advacare Clinics,ltd | Clinic/Center | 5001 American Blvd W, Ste.945, Bloomington, MN 55437-1108 | 2007-11-30 |
| 1528108941 | Cook Family Health Center | Clinic/Center | 402 N Rogers St, Bloomington, IN 47404-3740 | 2007-02-07 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 83223 |
Please comment or provide details below to improve the information on CLOVER CREEK MEDICAL.
| 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.