MOUNTAIN WEST MEDICAL SERVICES PLLC (NPI# 1457894339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457894339 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN WEST MEDICAL SERVICES PLLC |
| Practice Address |
1067 S Wells St Suite#110 Meridian ID 83642-7997 |
| Practice Telephone | 2082298739 |
| Practice Fax Number | 2088958540 |
| Mailing Telephone | 2082298739 |
| Mailing Fax Number | 2088958540 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2017-07-14 |
| Authorized Official Name | DR. JOHN KENNETH MCRAE (DR. OF NURSE PRACTIONER) |
| Authorized Official Telephone | 2082298739 |
| Authorized Official Credential | DNP, NPH, BSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
54169 | ID | Ambulatory Health Care Facilities |
| Street Address |
1067 S WELLS ST SUITE#110 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-7997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558438903 | Lon Chad Mcrae | Dentist | 1067 S Wells St, Meridian, ID 83642-7997 | 2006-11-29 |
| 1518581370 | Chelsea Ann Hansen | Dental Hygienist | 1067 S Wells St, Meridian, ID 83642-7997 | 2020-06-07 |
| 1033777891 | Caroline Sewell | Dentist | 1067 S Wells St, Meridian, ID 83642-7997 | 2019-06-05 |
| 1720512478 | Katy Pearce | Dentist | 1067 S Wells St, Meridian, ID 83642-7997 | 2017-04-19 |
| 1750838504 | John Mcrae | Nurse Practitioner | 1067 S Wells St, Meridian, ID 83642-7997 | 2016-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1457983462 | Amh Series II Id, LLC | Clinic/Center | 3875 E Overland Rd Ste 1e, Meridian, ID 83642-9005 | 2020-02-07 |
| 1275186835 | Bella Family Healthcare & Aesthetics | Clinic/Center | 1545 E Leighfield Dr Ste 100, Meridian, ID 83646-5371 | 2019-07-22 |
| 1821032376 | Saint Alphonsus Physician Services Inc | Clinic/Center | 3250 W Cherry Ln, Meridian, ID 83642-1120 | 2006-06-15 |
| 1891355392 | Kaylor Family Medicine Pllc | Clinic/Center | 2536 N Stokesberry Pl, Meridian, ID 83646-1144 | 2019-06-17 |
| 1841603768 | Treasure Valley Family Medicine, Pllc | Clinic/Center | 2428 N Stokesberry Pl, Meridian, ID 83646-5035 | 2014-06-09 |
| 1033424429 | Borron Family Medicine Pllc | Clinic/Center | 790 W Ustick Rd, Ste 110, Meridian, ID 83646-5558 | 2010-08-10 |
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| 1073031118 | Clover Creek Medical | Clinic/Center | 175 North Main Street, Bloomington, ID 83223-8322 | 2017-09-08 |
| 1104351972 | Salmon River Clinic | Clinic/Center | 102 Courthouse Dr, Suite F, Salmon, ID 83467-3904 | 2017-04-28 |
| 1154877918 | Boise House Calls, LLC | Clinic/Center | 303 Elk Creek Road, Suite Box 88, Idaho City, ID 83631 | 2016-08-31 |
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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.