DR. WENDELL E PETTY (NPI# 1457312308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457312308 |
Entity Type | Individual |
Full Name | DR. WENDELL E PETTY |
Other Name | DR. GENE PETTY |
Credential | M.D. |
Practice Address |
3422 S 15th E Idaho Falls ID 83404-8262 |
Practice Telephone | 2085299292 |
Practice Fax Number | 2085256013 |
Mailing Telephone | 2085299292 |
Mailing Fax Number | 2085256013 |
Enumeration Date | 2006-03-30 |
Last Update Date | 2019-06-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207K00000X | Allergy & Immunology | MD-2580 | ID | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | BLUE SHIELD | 000010004631 | 01 |
ID | 002516900 | 05 | |
ID | RAILROAD MEDICARE | 030000684 | 01 |
ID | BLUE CROSS | 76891 | 01 |
Street Address |
3422 S 15TH E |
City | IDAHO FALLS |
State | ID |
Zip Code | 83404-8262 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285621532 | Michael T Harris Md, PC | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2005-10-03 |
1760044424 | Phillip Marlowe | Radiologic Technologist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2019-07-02 |
1215314968 | Hsiang-hua Wang | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2015-05-01 |
1114343985 | Kelly Stark | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2014-03-17 |
1912335738 | Family Resource Centers of America, Inc | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2013-10-15 |
1164712899 | Sawtooth Rehab, Pllc | Specialist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-04-14 |
1720387681 | Travis Scott Hull | Social Worker | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-03-17 |
1376877795 | David Aaron Petty | Allergy & Immunology | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-10-01 |
1235363169 | Maria Teresa Alvarado | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-05-06 |
1982841334 | Karen Elise Bender | Registered Nurse | 3422 S 15th E, The Healing Sanctuary, Idaho Falls, ID 83404-8262 | 2009-01-07 |
Find all providers in the same location |
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 | 207K00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Allergy & Immunology |
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003949298 | Idaho Allergy & Asthma Clinic Pa | Allergy & Immunology | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2007-03-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396972311 | Jeremy David Waldram | Allergy & Immunology | 1000 N Curtis Rd Ste 303, Boise, ID 83706-1347 | 2009-06-17 |
1679569149 | Michael V Keiley | Allergy & Immunology | 901 N Curtis Rd, Ste 100, Boise, ID 83706-1394 | 2005-09-21 |
1215061734 | Boise Valley Asthma & Allergy Pa | Allergy & Immunology | 901 N Curtis Rd, Suite 100, Boise, ID 83706-1394 | 2007-03-15 |
1316979974 | Allergy Group PC | Allergy & Immunology | 1000 N Curtis Rd, Ste 303, Boise, ID 83706 | 2006-07-06 |
1972578672 | Gregory Mathew Wickern | Allergy & Immunology | 800 Falls Ave, Suite #2, Twin Falls, ID 83301-3366 | 2006-02-17 |
1417943622 | John D Jeppson | Allergy & Immunology | 901 N Curtis Rd, Suite 100, Boise, ID 83706-1394 | 2005-09-22 |
1033105259 | George William Palmer | Allergy & Immunology | 901 N Curtis Rd, Ste 100, Boise, ID 83706-1394 | 2005-09-22 |
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.