HAILEY M GORDON (NPI# 1275175291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275175291 |
| Entity Type | Individual |
| Full Name | HAILEY M GORDON |
| Credential | PA-C |
| Practice Address |
6052 W State St Boise ID 83703-2739 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2083447799 |
| Practice Fax Number | 2083447152 |
| Mailing Telephone | 2089556500 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 53504 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689110199 | Hailey Gordon | Physical Therapy Assistant | 906 E Matthews Ave, Jonesboro, AR 72401-3050 | 2017-01-09 |
| Street Address |
6052 W STATE ST |
| City | BOISE |
| State | ID |
| Zip Code | 83703-2739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386635977 | Nathan John Church | Physician Assistant | 6052 W State St, Boise, ID 83703-2739 | 2005-11-02 |
| 1659939031 | Brian C Cey | Nurse Practitioner | 6052 W State St, Boise, ID 83703-2739 | 2019-05-31 |
| 1467803957 | Brenna Elizabeth Sweeney | Specialist/Technologist | 6052 W State St, Boise, ID 83703-2739 | 2016-06-25 |
| 1033595905 | Ryan Anthony Baugher | Family Medicine | 6052 W State St, Boise, ID 83703-2739 | 2015-08-03 |
| 1871904698 | Matthew Mors | Otolaryngology | 6052 W State St, Boise, ID 83703-2739 | 2014-05-14 |
| 1285068056 | Valerie Romanello | Physical Therapist | 6052 W State St, Boise, ID 83703-2739 | 2013-08-28 |
| 1902230923 | Barbara Susan Kerr | Physical Therapist | 6052 W State St, Boise, ID 83703-2739 | 2013-08-27 |
| 1245522036 | Kelly Catherine Wilkinson | Family Medicine | 6052 W State St, Boise, ID 83703-2739 | 2011-05-11 |
| 1396981643 | Alliance Medical Group, LLC | Family Medicine | 6052 W State St, Boise, ID 83703-2739 | 2008-12-16 |
| 1568608800 | Alliance Medical Group, LLC | Clinic/Center | 6052 W State St, Boise, ID 83703-2739 | 2008-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588288336 | Katina Ross | Nurse Practitioner | 11695 W Baserri Dr, Boise, ID 83709-1307 | 2020-06-07 |
| 1932741212 | Kylie B Di Lulo | Nurse Practitioner | 1309 E Fall Ct, Boise, ID 83706-5076 | 2019-10-08 |
| 1033638150 | Michael P Lorentzen | Nurse Practitioner | 190 E Bannock St Fl 9, Boise, ID 83712-6241 | 2017-09-11 |
| 1063786648 | Tennessee Phs PC | Nurse Practitioner | 950 W. Bannock Street, Suite 1100, Boise, ID 83702-6140 | 2012-02-29 |
| 1194093344 | Ella Mae Gordon | Nurse Practitioner | 450 West State Street, 4th Floor, Boise, ID 83720-0036 | 2011-12-02 |
| 1174839666 | Meghann R Bostrom | Nurse Practitioner | 13099 W Paint Dr, Boise, ID 83713-1927 | 2010-08-23 |
| 1255653796 | Natalia Khochay | Nurse Practitioner | 1075 N. Curtis Rd., Suite 200, Boise, ID 83706-1300 | 2010-02-25 |
| 1164670378 | Janet Mcreynolds Pelton | Nurse Practitioner | 2074 Roanoke Dr, Boise, ID 83712-7529 | 2008-08-29 |
| 1619155249 | Loreen Anne Nugent | Nurse Practitioner | 3611 Tamarack Dr, Boise, ID 83703-4551 | 2008-02-06 |
| 1891904132 | Mario P Martinez | Nurse Practitioner | 1075 S Curtis Rd, Suite 200, Boise, ID 83706-1350 | 2007-05-22 |
| Find all providers in BOISE | ||||
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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.