DR. KURT J NILSSON (NPI# 1477581122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477581122 |
| Entity Type | Individual |
| Full Name | DR. KURT J NILSSON |
| Credential | MD |
| Practice Address |
1109 W Myrtle St Suite 200 Boise ID 83702-6970 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083830201 |
| Practice Fax Number | 2084894300 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2013-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
M8827 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
1109 W MYRTLE ST SUITE 200 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801249545 | Zachary Braddock | Physical Therapist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2016-07-18 |
| 1194193334 | Candice Chessum | Physical Therapist | 1109 W Myrtle St, Boise, ID 83702-6970 | 2015-09-04 |
| 1083015929 | Julia Hassell | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2014-09-10 |
| 1982940011 | Lucas Bahnmaier | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2012-12-18 |
| 1831475284 | Timothy Steven Nicolello | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2011-10-31 |
| 1992089858 | Joel Eric Vander Lugt | Physical Therapist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2011-10-10 |
| 1639372709 | Forrest Q Pecha | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2007-06-07 |
| 1518978337 | Alejandro A Homaechevarria | Family Medicine | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-08-10 |
| 1780694182 | Erik J Heggland | Orthopaedic Surgery | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508152257 | Tobias P Gopon | Family Medicine | 600 N Robbins Rd Ste 400, Boise, ID 83702-4566 | 2011-06-21 |
| 1215137526 | Dean Edward Lapinel | Family Medicine | 1437 E Braemere Rd, Boise, ID 83702-1857 | 2007-07-24 |
| 1881629202 | Craig M Smith | Family Medicine | 5959 N Discovery Place, Boise, ID 83713-1556 | 2006-07-12 |
| 1366822892 | Kaleb Redden | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2015-05-29 |
| 1417143926 | Richard Radnovich Do PC | Family Medicine | 4850 N Rosepoint Way, Suite 100, Boise, ID 83713-5262 | 2007-09-18 |
| 1407944655 | Richard Radnovich | Family Medicine | 4850 N Rosepoint Way, Ste 100, Boise, ID 83713 | 2006-10-11 |
| 1518978337 | Alejandro A Homaechevarria | Family Medicine | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-08-10 |
| 1043216823 | Scot B Scheffel | Family Medicine | 1188 University Dr, Boise, ID 83706 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1801292115 | Idaho State University | Family Medicine | 921 S 8th Ave Stop 8173, Sports and Orthopaedic Center, Pocatello, ID 83209-8173 | 2014-11-13 |
| 1659870517 | Orthoidaho LLC | Family Medicine | 2240 E Center St, Pocatello, ID 83201-2600 | 2018-02-06 |
| 1295094217 | James Kendall Christensen | Family Medicine | 2375 E Sunnyside Rd, Ste F, Idaho Falls, ID 83404-8280 | 2012-05-11 |
| 1770877888 | Anthony Joseph Md Inc | Family Medicine | 333 N 18th Ave, Suite D-1, Pocatello, ID 83201-3358 | 2011-06-06 |
| 1033417035 | Idaho Sports & Spine Pllc | Family Medicine | 950 Hospital Way, Ste A, Pocatello, ID 83201-2789 | 2011-03-01 |
| 1124115944 | Tony C Roisum Md Pa | Family Medicine | 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404-8333 | 2006-10-05 |
| 1528092202 | Christopher R Johnson | Family Medicine | 950 Hospital Way, Suite A, Pocatello, ID 83201-2789 | 2006-07-10 |
| 1922092741 | Anthony E Joseph | Family Medicine | 2240 E Center St, Pocatello, ID 83201-2600 | 2005-09-08 |
Please comment or provide details below to improve the information on DR. KURT J NILSSON.
| 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.