ALLIANCE MEDICAL GROUP, LLC (NPI# 1568413920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568413920 |
| Entity Type | Organization |
| Organization Name | ALLIANCE MEDICAL GROUP, LLC |
| Other Organization Name | PRIMARY HEALTH MEDICAL GROUP |
| Practice Address |
10482 W Carlton Bay Dr Garden City ID 83714-5143 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2089556500 |
| Practice Fax Number | 2089556503 |
| Mailing Telephone | 2089556500 |
| Mailing Fax Number | 2089556503 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-01-07 |
| Authorized Official Name | DR. DAVID L PETERMAN (PRESIDENT) |
| Authorized Official Telephone | 2089556500 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807138900 | 05 | |
| ID | 807139000 | 05 |
| 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 |
| 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 |
| 1871969246 | Alliance Medical Group, LLC | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2015-08-19 |
| Street Address |
10482 W CARLTON BAY DR |
| City | GARDEN CITY |
| State | ID |
| Zip Code | 83714-5143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
| 1437608007 | Carrie Boroughs Breaux | Ophthalmology | 5019 N Sawyer Ave, Garden City, ID 83714 | 2016-09-23 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1134580467 | Rebecca Gillet | Physical Therapist | 6576 W Dufferin Ct, Boise, ID 83714 | 2016-03-15 |
| 1063816007 | Ingri Suzanne Koloski | Counselor | 8969 West Hepburn Lane, Garden City, ID 83714 | 2014-10-20 |
| 1679909329 | Anile Nina | Counselor | 5484 N Gary Lane, Boise, ID 83714 | 2013-09-25 |
| 1215360292 | William Blake Bybee | Dentist | 5833 W. Hidden Springs Dr., Boise, ID 83714 | 2013-08-14 |
| 1871833327 | Charmaine Read | Social Worker | 123 E. 44th St, Ste. A, Garden City, ID 83714 | 2013-02-20 |
| 1811206576 | Bennett Medical Services | Durable Medical Equipment & Medical Supplies | 5220 Sawyer Court, Suite D, Garden City, ID 83714 | 2010-09-29 |
| 1073780680 | Barry Lynn Williams | Pharmacist | 7020 W State Street, Boise, ID 83714 | 2008-05-13 |
| Find all providers in zip 83714 | ||||
| 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 |
|---|---|---|---|---|
| 1134616832 | Robin L. Lipski D.o PC | Family Medicine | 6255 Inkster Rd Ste 304, Garden City, MI 48135-2538 | 2018-04-18 |
| 1881135234 | New Hope Together, Inc. | Family Medicine | 603 E Labrador Blvd, #4, Garden City, KS 67846-3292 | 2017-03-18 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1003297102 | Marcus Ng | Family Medicine | 1001 Franklin Ave Rm 110, Garden City, NY 11530-2901 | 2015-06-15 |
| 1588845655 | Richard Wallace Thomas | Family Medicine | 6b Crager Ct, Garden City, GA 31408-1314 | 2007-11-17 |
| 1508072729 | Prime Garden City Medical Group | Family Medicine | 30730 Ford Road, Garden City, MI 48135 | 2007-05-15 |
| 1053533844 | St. Catherine Hospital | Family Medicine | 311 E Spruce Street, Garden City, KS 67846 | 2007-05-03 |
| 1861411969 | Betty Ann Kelly | Family Medicine | Bldg. #19, West Rd., Mitchel Complex Family Health Center, Garden City, NY 11530 | 2006-07-19 |
| 1558394627 | Maria Krichever | Family Medicine | 109 Minis Ave, Suite C-10, Garden City, GA 31408-2128 | 2006-07-09 |
| 1174550313 | James Dale Lawrenzi | Family Medicine | 101 B Old 7 Hwy., Garden City, MO 64747-0469 | 2006-06-26 |
| Find all providers in GARDEN CITY | ||||
| City | GARDEN CITY |
| Zip Code | 83714 |
Please comment or provide details below to improve the information on ALLIANCE MEDICAL GROUP, LLC.
| 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.