NATALIE A DOMANGUE-SHIFLETT (NPI# 1376510123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376510123 |
| Entity Type | Individual |
| Full Name | NATALIE A DOMANGUE-SHIFLETT |
| Other Name | NATALIE A SHIFLETT |
| Credential | MD |
| Practice Address |
4740 N Penngrove Way Ste 100 Meridian ID 83646 |
| Practice Telephone | 2089383663 |
| Practice Fax Number | 2089383664 |
| Mailing Telephone | 2089383663 |
| Mailing Fax Number | 2089383664 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2019-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M-9985 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | H36269 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4740 N Penngrove Way, Ste 100, Meridian, ID 83646 | 2089650905 |
| Street Address |
4740 N PENNGROVE WAY STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669934220 | Thrive Pediatrics LLC | Pediatrics | 4740 N Penngrove Way, Meridian, ID 83646 | 2019-04-03 |
| 1982115309 | Laura Eaton | Nurse Practitioner | 4740 N Penngrove Way, Ste 100, Meridian, ID 83646 | 2017-10-12 |
| 1457652661 | Julie Joanna Franden | Nurse Practitioner | 4740 N Penngrove Way, Ste 100, Meridian, ID 83646 | 2010-11-04 |
| 1730414947 | Josie F Farmer | Nurse Practitioner | 4740 N Penngrove Way, Ste 100, Meridian, ID 83646 | 2009-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1356977466 | Tanabell Health Services Inc | Assisted Living Facility | 2584 E Magic View Dr, Meridian, ID 83646 | 2020-03-20 |
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1639644107 | Joseph Anomalay | Counselor | 6700 N. Linder Rd, Ste 156 #257, Meridian, ID 83646 | 2018-10-10 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1134511264 | Brittany Laub | Massage Therapist | 2572 N Stokesberry Pl #300, Meridian, ID 83646 | 2015-02-26 |
| 1194117366 | Westfall Ventures, Inc | Health Maintenance Organization | 2572 N. Stokesberry Pl, Meridian, ID 83646 | 2015-02-25 |
| Find all providers in zip 83646 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| 1023506466 | Vast Durable Medical Equipment Inc | Family Medicine | 2985 S Meridian Rd Ste 140, Meridian, ID 83642-7961 | 2018-04-30 |
| 1235651498 | Carmeshia M Cain | Family Medicine | 1312 22nd Ave Ste A, Meridian, MS 39301-4015 | 2017-07-10 |
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1619397064 | Sara Jane Aney | Family Medicine | 4949 S Hillsdale Ave, Meridian, ID 83642-7586 | 2014-04-24 |
| 1033534276 | Alliance Medical Group, LLC | Family Medicine | 1623 South Wells Avenue, Meridian, ID 83642 | 2014-02-25 |
| 1275979346 | Matthew Robert Sara | Family Medicine | 1648 Nw 1st St, Meridian, ID 83642-2212 | 2013-05-16 |
| 1093074577 | Marisa A Battaglia | Family Medicine | 1623 Wells Ave, Meridian, ID 83642-5040 | 2012-05-03 |
| 1891051942 | Louise Xian Ye-liew | Family Medicine | 2965 East Tarpon, Suite 150, Meridian, ID 83642 | 2012-04-03 |
| 1912221318 | Unity Health Center Pllc | Family Medicine | 1130 E Fairview Ave, Meridian, ID 83642-1813 | 2010-03-15 |
| Find all providers in MERIDIAN | ||||
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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.