RICHARD ALAN BLATTER (NPI# 1154682565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154682565 |
| Entity Type | Individual |
| Full Name | RICHARD ALAN BLATTER |
| Credential | D.O. |
| Practice Address |
2001 S Woodruff Ave Ste 4 Idaho Falls ID 83404-6371 |
| Practice Telephone | (208) 524-4511 |
| Practice Fax Number | 2085244540 |
| Mailing Telephone | (208) 524-4511 |
| Mailing Fax Number | 2085244540 |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | O-1041 | ID | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | O-1041 | MI | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 5315055574 | MI | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 5101019997 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1154682565 | 05 | |
| ID | IDAHO STATE LICENSE | O-1041 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 909 Fee Rd, Msu/gmei Uro Surgery, West Fee Hall, Room B415, East Lansing, MI 488246537 | 5173538470 | 5174321074 |
| Street Address |
2001 S WOODRUFF AVE STE 4 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-6371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033121322 | Timothy Osborn Taylor | Urology | 2330 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-13 |
| 1679528632 | Duncan Dwaynne Harris | Urology | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2006-05-24 |
| 1972604494 | Roger H Tall | Urology | 2001 S Woodruff, Suite 8, Idaho Falls, ID 83404 | 2006-09-26 |
| 1326032939 | Peter M Cannon | Urology | 2001 S Woodruff Ave, Suite 4, Idaho Falls, ID 83404-6374 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699242123 | Treasure Valley Urology Pllc | Urology | 3090 E Gentry Way Ste 220, Meridian, ID 83642-3550 | 2018-11-02 |
| 1750648002 | Jason Orien | Urology | 777 Hospital Way Ste 215, Pocatello, ID 83201-5175 | 2012-04-11 |
| 1972892669 | David Flores | Urology | 980 W Ironwood Dr Ste 104, Coeur D Alene, ID 83814-2668 | 2011-04-04 |
| 1346407921 | Helen Jia-ru Kuo | Urology | 2855 E. Magic View Drive, Meridian, ID 83642 | 2008-05-21 |
| 1144344391 | Robert W. Bohus, M.d., F.a.c.s. | Urology | 500 S 11th Ave Ste 301, Pocatello, ID 83201-4879 | 2007-03-16 |
| 1346375235 | Edward D Ellison | Urology | 980 Ironwood Dr W, Ste 104, Coeur D' Alene, ID 83814 | 2007-02-22 |
| 1316028889 | Edwin Manley Briggs | Urology | 1316 Harrison Blvd, Boise, ID 83702-3444 | 2006-10-18 |
| 1710097068 | Jared G Heiner | Urology | 3085 E Magic View Dr Ste 140, Meridian, ID 83642-3745 | 2006-08-30 |
| 1689617722 | A P Mclaughlin IIi Apc | Urology | 120 N Leadville, Ketchum, ID 83340 | 2006-06-14 |
| 1194763151 | Donald L Weese, M.d., P.C. | Urology | 844 Washington St N, Number 400, Twin Falls, ID 83301-3874 | 2006-06-03 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.