LARRY BISHOP (NPI# 1134178403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134178403 |
| Entity Type | Individual |
| Full Name | LARRY BISHOP |
| Credential | MD |
| Practice Address |
305 E Jefferson St Suite 101 Boise ID 83712-6273 |
| Mailing Address |
305 E Jefferson St Boise ID 83712-6274 |
| Practice Telephone | 2083450715 |
| Practice Fax Number | 2083451142 |
| Mailing Telephone | 2083450715 |
| Mailing Fax Number | 2083451142 |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | M-3771 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255325049 | Larry S Bishop | Dermatology | 7125 Murrell Rd, Melbourne, FL 32940-7999 | 2005-09-07 |
| 1770789943 | Larry Michael Bishop | Internal Medicine | 359 2nd Ave, New York, NY 10010-7436 | 2007-06-25 |
| Street Address |
305 E JEFFERSON ST SUITE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962491415 | Lynn M Luginbuhl | Pediatrics | 305 E Jefferson St, Boise, ID 83712-6273 | 2005-10-18 |
| 1366060147 | Bailey Severe | Genetic Counselor, MS | 305 E Jefferson St, Boise, ID 83712-6231 | 2020-07-08 |
| 1033748124 | Kody Michael Duclos | Dietitian, Registered | 305 E Jefferson St, Boise, ID 83712-6231 | 2020-04-02 |
| 1568826204 | Kelsy Newton | Psychologist | 305 E Jefferson St, Boise, ID 83712-6273 | 2016-04-08 |
| 1912272014 | Sean Timpane | Pediatrics | 305 E Jefferson St, Boise, ID 83712-6231 | 2012-03-21 |
| 1023306966 | Paul Christian Neville | Optometrist | 305 E Jefferson St, Boise, ID 83712-6273 | 2011-07-13 |
| 1699071217 | Samantha Cragg | Physical Medicine & Rehabilitation | 305 E Jefferson St, Boise, ID 83712-6231 | 2011-01-28 |
| 1891005716 | Malia Lynn Frazier | Nurse Practitioner | 305 E Jefferson St, Boise, ID 83712-6273 | 2010-10-13 |
| 1437467644 | Jaeger A Ashton | Nurse Practitioner | 305 E Jefferson St, Boise, ID 83712-6273 | 2010-09-22 |
| 1801059209 | Cheryl Higer | Dentist | 305 E Jefferson St, Boise, ID 83712-6273 | 2008-07-07 |
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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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437577483 | Kaitlin Burke | Pediatrics | 100 E Idaho St Ste 401, Boise, ID 83712-6267 | 2014-04-06 |
| 1780918748 | Jerome Anthony Hirschfeld | Pediatrics | 3101 E Nature Dr, Boise, ID 83706-6921 | 2009-09-23 |
| 1306020086 | Ann Catherine Miller | Pediatrics | 6348 Emerald St, Boise, ID 83642-2376 | 2007-12-18 |
| 1851588644 | Richard Epes Rainey | Pediatrics | 2100 N Larch St, Boise, ID 83706-1022 | 2007-09-26 |
| 1265544894 | Julie S Kikuchi | Pediatrics | 121 E Fort St, Boise, ID 83712-6322 | 2006-08-31 |
| 1174544829 | Allyson Ann Vansteenbergen | Pediatrics | 13960 W. Wainwright Dr., Suite B, Boise, ID 83713 | 2006-07-21 |
| 1609805779 | Ada Pediatrics, P.a. | Pediatrics | 650 N Cole Rd, Boise, ID 83704-9117 | 2006-07-01 |
| 1487693099 | John P Jambura | Pediatrics | 7722 Ustick Rd, Boise, ID 83704-5845 | 2006-06-06 |
| 1730131905 | Angella M Zieba | Pediatrics | 6348 W Emerald St, Boise, ID 83704-8732 | 2006-05-16 |
| 1194773804 | Ben H. Godfrey | Pediatrics | 450 W State St, Suite 100, Boise, ID 83702-6056 | 2006-05-05 |
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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.