MRS. MELISSA LEE PARK (NPI# 1386676039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386676039 |
| Entity Type | Individual |
| Full Name | MRS. MELISSA LEE PARK |
| Other Name | MELISSA LEE BROOMHALL |
| Credential | MD |
| Practice Address |
1203 Idaho St Lewiston ID 83501-1940 |
| Mailing Address |
611 N Iron Bridge Way Spokane WA 99202-4932 |
| Practice Telephone | 5094448888 |
| Mailing Telephone | 5094448888 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | M-10546 | ID | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 015943 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 808286200 | 05 | |
| ME | 431898000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 803 S Main St Ste 120, Moscow, ID 838432695 | 2084594667 | 2084593372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598922478 | Melissa D Park | Social Worker | 31625 Highway 101 S, Soledad, CA 93960-9529 | 2008-05-19 |
| Street Address |
1203 IDAHO ST |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-1940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145401 | Rachel Marie Rudder | Nurse Practitioner | 1203 Idaho St, Lewiston, ID 83501-1940 | 2020-08-19 |
| 1669015244 | Community Health Association of Spokane | Pharmacy | 1203 Idaho St, Lewiston, ID 83501-1940 | 2019-10-25 |
| 1508412164 | Lembi Che | Nurse Practitioner | 1203 Idaho St, Lewiston, ID 83501-1940 | 2019-08-09 |
| 1386112472 | Selam Kiflemichael | Pharmacist | 1203 Idaho St, Lewiston, ID 83501-1940 | 2018-11-06 |
| 1073040515 | Candice Klemens | Physician Assistant | 1203 Idaho St, Lewiston, ID 83501-1940 | 2017-05-15 |
| 1073062295 | Spencer Godfrey | Nurse Practitioner | 1203 Idaho St, Lewiston, ID 83501-1940 | 2016-09-28 |
| 1932561115 | Brandon W. Clark | Social Worker | 1203 Idaho St, Lewiston, ID 83501-1940 | 2016-03-25 |
| 1598190217 | Rachel Eron Clements | Nurse Practitioner | 1203 Idaho St, Lewiston, ID 83501-1940 | 2013-09-12 |
| 1609114750 | Community Health Association of Spokane | Clinic/Center | 1203 Idaho St, Lewiston, ID 83501-1940 | 2013-01-24 |
| 1710233176 | Wendy Klemm | Pharmacist | 1203 Idaho St, Lewiston, ID 83501-1940 | 2012-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639304041 | James P Moore | Internal Medicine | 4500 Lower River Rd, Lewiston, NY 14092-1057 | 2009-05-29 |
| 1780736884 | Alberta Borgese Micale | Internal Medicine | 445 Fort Gray Drive, Lewiston, NY 14092 | 2007-01-17 |
| 1184646234 | William P Thomas | Internal Medicine | 93 Campus Ave Ste G025, Lewiston, ME 04240 | 2006-07-24 |
| 1063445385 | Jane A Fore | Internal Medicine | 415 Sixth St, Lewiston, ID 83501 | 2006-07-09 |
| 1629007232 | Anne Jc Brown | Internal Medicine | 198 Main St Ste A, Lewiston, ME 04240-7074 | 2006-07-03 |
| 1942237490 | Jeffrey L Brown | Internal Medicine | 99 Campus Avenue, Suite 201, Lewiston, ME 04240 | 2006-06-27 |
| 1922079037 | Patricia Ann Brady | Internal Medicine | 222 Southway Ave, Ste C, Lewiston, ID 83501-2703 | 2006-01-27 |
| 1518958412 | Elzbieta E Kraszewska-ostromecka | Internal Medicine | 341 Saint Johns Way, Lewiston, ID 83501-2436 | 2005-10-31 |
| 1457356990 | R Scott Hanson | Internal Medicine | 15 Challenger Dr, Lewiston, ME 04240-1041 | 2005-06-20 |
| 1184252751 | Mount St. Mary's Hospital of Niagara Falls | Internal Medicine | 5300 Military Rd, Lewiston, NY 14092-1903 | 2020-03-30 |
| Find all providers in LEWISTON | ||||
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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.