ALLIANCE MEDICAL GROUP, LLC (NPI# 1396981643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396981643 |
| Entity Type | Organization |
| Organization Name | ALLIANCE MEDICAL GROUP, LLC |
| Other Organization Name | PRIMARY HEALTH MEDICAL GROUP |
| 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 |
| Mailing Fax Number | 2089556503 |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2011-02-18 |
| Authorized Official Name | DAVID PETERMAN (PRESIDENT) |
| Authorized Official Telephone | 2089556522 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primary Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1033534276 | Alliance Medical Group, LLC | Family Medicine | 1623 South Wells Avenue, Meridian, ID 83642 | 2014-02-25 |
| 1770729063 | Alliance Medical Group, LLC | Pediatrics | 3280 E. Lanark Drive, Meridian, ID 83642 | 2008-12-17 |
| 1497991749 | Alliance Medical Group, LLC | Family Medicine | 1907 Broadway Ave, Suite 101, Boise, ID 83706-4201 | 2008-12-16 |
| 1568413920 | Alliance Medical Group, LLC | Family Medicine | 10482 W Carlton Bay Dr, Garden City, ID 83714-5143 | 2006-05-12 |
| 1124641188 | Alliance Medical Group, LLC | Family Medicine | 1475 N Cole Rd, Boise, ID 83704-8537 | 2020-05-26 |
| 1073079463 | Alliance Medical Group, LLC | Family Medicine | 512 N 21st Ave, Caldwell, ID 83605-4368 | 2019-02-11 |
| 1457868002 | Alliance Medical Group, LLC | Family Medicine | 1375 N Happy Valley Rd, Nampa, ID 83687-5280 | 2018-01-04 |
| 1386003770 | Alliance Medical Group, LLC | Family Medicine | 1900 W. Chinden Blvd., Meridian, ID 83646 | 2016-02-15 |
| 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 |
| 1275175291 | Hailey M Gordon | Nurse Practitioner | 6052 W State St, Boise, ID 83703-2739 | 2019-10-10 |
| 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 |
| 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 | 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 |
|---|---|---|---|---|
| 1790269389 | Erin Michelle Love Mcdermott | Family Medicine | 2402 W Jefferson St, Boise, ID 83702-4811 | 2018-09-19 |
| 1336656040 | Functional Medicine of Idaho PC | Family Medicine | 3858 N Garden Center Way Ste 100, Boise, ID 83703-5008 | 2018-01-03 |
| 1922456870 | Daniel Luftig | Family Medicine | 1041 S Dale St Apt 302, Boise, ID 83706-7641 | 2016-06-01 |
| 1942676598 | Robert F. Smith, Md, Pllc | Family Medicine | 320 N Collins Rd, Boise, ID 83702-4519 | 2015-08-18 |
| 1861827222 | Treasure Valley Neuropathy Relief Center PC | Family Medicine | 1755 N Westgate Dr, Suite 200, Boise, ID 83704-7174 | 2013-09-04 |
| 1205272986 | Shahla Walizada | Family Medicine | 2141 E Parkcenter Blvd, Samg Bhp Family Medicine, Boise, ID 83706 | 2013-05-21 |
| 1891057246 | Kara Mackenzie Kuntz | Family Medicine | 5966 W Curtisian Road, Boise, ID 83704 | 2012-06-12 |
| 1922366707 | Cottonwood Family Medicine | Family Medicine | 100 Cottonwood Court, Suite 150, Boise, ID 87616 | 2012-04-30 |
| 1720377476 | Steven Schneider | Family Medicine | 3775 W Quail Hollow Dr, Boise, ID 83703-3869 | 2011-04-04 |
| 1922311042 | Amber Vania | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2010-07-18 |
| 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.