UPPER VALLEY ENT & ALLERGY PLLC (NPI# 1124462494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124462494 |
| Entity Type | Organization |
| Organization Name | UPPER VALLEY ENT & ALLERGY PLLC |
| Practice Address |
256 N 2nd E Rexburg ID 83440-1638 |
| Practice Telephone | 2086569646 |
| Practice Fax Number | 2086569645 |
| Mailing Telephone | 2086569646 |
| Mailing Fax Number | 2086569645 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2014-06-11 |
| Authorized Official Name | DR. JAY ROBERT MCMASTER (PHYSICIAN/SURGEON) |
| Authorized Official Telephone | 2086569646 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
Allopathic & Osteopathic Physicians | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
256 N 2ND E |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-1638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962438812 | Dan Loren Weber | Physician Assistant | 256 N 2nd E, Rexburg, ID 83440-1638 | 2006-06-23 |
| 1447456272 | Barry John Peterson | Allergy & Immunology | 256 N 2nd E, Rexburg, ID 83440-1638 | 2007-06-27 |
| 1174693543 | Chris Chad Fugate | Nurse Anesthetist, Certified Registered | 256 N 2nd E, Rexburg, ID 83440-1638 | 2006-11-09 |
| 1972537892 | Jay Robert Mcmaster | Allergy & Immunology | 256 N 2nd E, Rexburg, ID 83440-1638 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768490 | Henry's Fork Surgery Center Pllc | Clinic/Center | 23 Sawtelle Ave, Rexburg, ID 83440 | 2020-04-08 |
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| Find all providers in zip 83440 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689945883 | Thomas John Mcdevitt | Otolaryngology | 237 South 7th Ave., Thomas J. Mcdevitt, Pocatello, ID 83205-4928 | 2012-01-19 |
| 1104932839 | Russell Turner Snow | Otolaryngology | 119 West Logan Street, Ste A, Caldwell, ID 83605 | 2006-08-23 |
| 1073824744 | Sennett Ames Pierce Sr | Otolaryngology | 330 Warner Dr, Lewiston, ID 83501-4441 | 2010-06-28 |
| 1750542452 | Kylan D Peterson | Otolaryngology | 730 N College Rd, Suite B, Twin Falls, ID 83301-3382 | 2008-06-24 |
| 1316162704 | Russell Weldon Mayes | Otolaryngology | 730 N College Rd, Suite B, Twin Falls, ID 83301-3382 | 2007-04-13 |
| 1306944772 | Alpine Ear, Nose & Throat, P.c | Otolaryngology | 2065 E 17th St, Suite B, Idaho Falls, ID 83404-8042 | 2006-09-20 |
| 1225011893 | Eric T Garner | Otolaryngology | 900 N Liberty St, Ste 400, Boise, ID 83704-8704 | 2005-11-28 |
Please comment or provide details below to improve the information on UPPER VALLEY ENT & ALLERGY PLLC.
| 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.