CASI MCPHERSON WYATT (NPI# 1083716153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083716153 |
| Entity Type | Individual |
| Full Name | CASI MCPHERSON WYATT |
| Other Name | CASI LYNN MCPHERSON |
| Credential | DO |
| Practice Address |
125 E Idaho St Suite 203 Boise ID 83712-6212 |
| Practice Telephone | 2083380148 |
| Practice Fax Number | 2083364027 |
| Mailing Telephone | 2083380148 |
| Mailing Fax Number | 2083364027 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2009-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 3714 | IA | Allopathic & Osteopathic Physicians |
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
O-0530 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0731364 | 05 | |
| IA | WELLMARK BCBS | 26705 | 01 |
| Street Address |
125 E IDAHO ST SUITE 203 |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659365575 | Sky R Blue | Internal Medicine | 125 E Idaho St, Suite 203, Boise, ID 83712-6212 | 2005-09-07 |
| 1447893896 | Caroline Murphy | Physician Assistant | 125 E Idaho St, Boise, ID 83712-6212 | 2019-10-17 |
| 1023409265 | Misty Neisen | Physician Assistant | 125 E Idaho St, Ste 303, Boise, ID 83712-6212 | 2015-02-10 |
| 1225167588 | Birgitt Lucille Dau | Internal Medicine | 125 E Idaho St, Suite 203, Boise, ID 83712-6212 | 2007-03-05 |
| 1366555971 | Harley Neil Sweeten | Physician Assistant | 125 E Idaho St, Suite 102, Boise, ID 83712-6212 | 2006-08-16 |
| 1427070929 | Ronald E Jutzy | Neurological Surgery | 125 E Idaho St, Suite 102, Boise, ID 83712-6212 | 2006-07-24 |
| 1942256953 | Rodney Riggs | Physician Assistant | 125 E Idaho St, Suite 303, Boise, ID 83712-6212 | 2006-05-25 |
| 1689629784 | Troy Britton | Nurse Anesthetist, Certified Registered | 125 E Idaho St, Suite 303, Boise, ID 83712-6212 | 2006-05-24 |
| 1093767527 | Michael P Naeve | Orthopaedic Surgery | 125 E Idaho St, Suite 102, Boise, ID 83712-6212 | 2006-05-16 |
| 1952351710 | Gerard Robert W. Klomp | Obstetrics & Gynecology | 125 E Idaho St, Suite 201, Boise, ID 83712-6212 | 2006-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710323126 | Jonathan Salberg | Internal Medicine | 125 E Idaho St Ste 100, Boise, ID 83712 | 2013-05-13 |
| 1659365575 | Sky R Blue | Internal Medicine | 125 E Idaho St, Suite 203, Boise, ID 83712-6212 | 2005-09-07 |
| 1174781959 | Christine Gabriele Hahn | Internal Medicine | 450 W State St, 4th Floor, Boise, ID 83702-6056 | 2008-05-28 |
| 1144307612 | Dennis Leroy Stevens | Internal Medicine | 500 W Fort St, Boise, ID 83702-4501 | 2006-11-01 |
| 1528076643 | Sharon E Oster | Internal Medicine | 403 S 11th St, #310, Boise, ID 83702-6968 | 2006-08-04 |
| 1245224823 | Thomas J Coffman | Internal Medicine | 125 E Idaho St, Suite 203, Boise, ID 83712-6212 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558522235 | Total Care LLC | Internal Medicine | 303 E Logan St, Caldwell, ID 83605-4863 | 2008-06-24 |
| 1083811475 | Sean Tristan Lawrence Cook | Internal Medicine | 2120 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2007-06-28 |
| 1013986579 | Hampton Roads Medical Specialists PC | Internal Medicine | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2006-03-16 |
| 1114992435 | Scott R Bressler | Internal Medicine | 303 E Logan, Caldwell, ID 83605 | 2006-02-21 |
| 1568760676 | Infectious Disease Medicine LLC | Internal Medicine | 1875 N Lakewood Dr Ste 101, Coeur D Alene, ID 83814-4928 | 2011-03-14 |
| 1891977278 | Melanie Enderwick | Internal Medicine | 2120 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2007-11-28 |
| 1477679496 | Stephen Lloyd Green | Internal Medicine | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2007-03-21 |
| 1588672026 | Idaho Falls Infectious Diseases, Pllc | Internal Medicine | 2900 Cortez Ave, Idaho Falls, ID 83404-7554 | 2006-08-03 |
| 1942229570 | Richard Alan Nathan | Internal Medicine | 2900 Cortez Ave, Idaho Falls, ID 83404-7554 | 2006-07-18 |
| 1598783128 | John Todd Bagwell | Internal Medicine | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2006-07-18 |
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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.