DR. ADAM WELLER (NPI# 1568634855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568634855 |
| Entity Type | Individual |
| Full Name | DR. ADAM WELLER |
| Credential | M.D. |
| Practice Address |
1000 State St Mccall ID 83638-3704 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2086342221 |
| Practice Fax Number | 2086347112 |
| Mailing Telephone | 2086342221 |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2016-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-12492 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1568634855 | 05 |
| Street Address |
1000 STATE ST |
| City | MCCALL |
| State | ID |
| Zip Code | 83638-3704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538107362 | Paul D Traughber | Radiology | 1000 State St, Mccall, ID 83638-3704 | 2006-06-03 |
| 1376163618 | Andrea Lingle | Pharmacist | 1000 State St, Mccall, ID 83638-3704 | 2020-04-16 |
| 1780224618 | Heidi Lee Galyardt | Pharmacist | 1000 State St, Mccall, ID 83638-3704 | 2020-01-08 |
| 1942849781 | Megan Hatt | Pharmacist | 1000 State St, Mccall, ID 83638-3704 | 2019-12-26 |
| 1821636853 | Jesse Cook | Pharmacist | 1000 State St, Mccall, ID 83638-3704 | 2019-12-20 |
| 1770927964 | Susan Mccandless | Dietitian, Registered | 1000 State St, Mccall, ID 83638-3704 | 2013-04-18 |
| 1881982510 | St Lukes Clinic - Mccall LLC | Emergency Medicine | 1000 State St, Mccall, ID 83638-3704 | 2011-07-15 |
| 1043528011 | St Lukes Mccall, Ltd | Medicare Defined Swing Bed Unit | 1000 State St, Mccall, ID 83638-3704 | 2010-09-23 |
| 1417265810 | St Lukes Mccall, Ltd | Anesthesiology | 1000 State St, Mccall, ID 83638-3704 | 2010-09-20 |
| 1235447970 | St Lukes Mccall Ltd | General Acute Care Hospital | 1000 State St, Mccall, ID 83638-3704 | 2010-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255897708 | Seanne Jo Safaii | Dietitian, Registered | 1100 Heaven's Gate Ct. #1910, Mccall, ID 83638 | 2019-02-20 |
| 1053881284 | Debra Ann Jones Yensen | Counselor | 1242 Herrick Street N, Mccall, ID 83638 | 2018-11-30 |
| 1306369681 | Cheyene Joseph Nickerson | Pharmacist | 132 East Lake Street, Mccall, ID 83638 | 2017-07-19 |
| 1669923892 | Amy Leigh Forkan | Massage Therapist | 301 E Park St., Mccall, ID 83638 | 2016-10-24 |
| 1770982597 | Rachel L Smith | Acupuncturist | 106 E. Park St, Suite 102, Mc Call, ID 83638 | 2014-08-18 |
| 1275944498 | Central Idaho Counseling, Pllc | Social Worker | 125 Commerce St., Suite B, Mccall, ID 83638 | 2014-05-09 |
| 1548690829 | Sze Wan Chan | Pharmacist | 1001 North 2nd Street, Mccall, ID 83638 | 2013-11-22 |
| 1467882274 | Tamara Nagoda | Speech-Language Pathologist | 304 Edgewater Circle, Mccall, ID 83638 | 2013-11-14 |
| 1457537896 | Thomas L Moore | Counselor | 310 E. Lake St., Tom Moore, Mccall, ID 83638 | 2008-01-16 |
| 1659581585 | Barbara Gail Norton | Social Worker | 125 Commerce St, Suite B, Mccall, ID 83638 | 2007-05-22 |
| Find all providers in zip 83638 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538107362 | Paul D Traughber | Radiology | 1000 State St, Mccall, ID 83638-3704 | 2006-06-03 |
| 1750490801 | Gregory D Mckim | Radiology | 1000 State St, Dept of Radiology, Mccall, ID 83638-3704 | 2006-08-30 |
| 1366475584 | Planet Three Radiology, Inc. | Radiology | 1000 State St, Mccall, ID 83638-3704 | 2006-07-09 |
| 1629001854 | Chance Enterprises, LLC | Radiology | 1000 State St, Mccall, ID 83638-3704 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518597285 | Katie Clegg | Radiology | 593 W 24th St, Burley, ID 83318-2803 | 2020-01-22 |
| 1376920553 | Creighton Lewis | Radiology | 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 | 2015-04-27 |
| 1598176448 | Derek A Khorsand | Radiology | Kootenai Health, 2003 Kootenai Way, Coeur D'alene, ID 83814 | 2014-05-14 |
| 1578903191 | Miriam Bryna Hulkower | Radiology | 1839 N Govt Way Ste B, Coeur D Alene, ID 83814-3454 | 2013-06-27 |
| 1750647913 | Philip John Dougherty | Radiology | 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 | 2012-04-02 |
| 1356510143 | Newell Kay Richardson | Radiology | 2088 E 49th South, Idaho Falls, ID 83404-7649 | 2008-02-26 |
| 1477733574 | Cameron J Evans | Radiology | 4121 N 2600 E, Filer, ID 83328-5155 | 2007-11-06 |
| 1295926061 | Michael Modica | Radiology | 877 W Main St, Suite 603, Boise, ID 83702-5883 | 2007-08-07 |
| 1972709590 | Stephen Arthur Sherman | Radiology | 4685 Flora Dr, Pocatello, ID 83204-4568 | 2007-06-21 |
| 1891999165 | Vidvuds Bandrevics | Radiology | 102 Canyon Rd, Hailey, ID 83333-5067 | 2007-06-12 |
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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.