MICHAEL MCCOMB (NPI# 1568778918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568778918 |
| Entity Type | Individual |
| Full Name | MICHAEL MCCOMB |
| Credential | PA |
| Practice Address |
4400 E Flamingo Ave Ste 200 Ste 200 Nampa ID 83687 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2083022700 |
| Practice Fax Number | 2083022725 |
| Mailing Telephone | (208) 302-2700 |
| Mailing Fax Number | 2083022725 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2017-08-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-1166 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA152966 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4400 E FLAMINGO AVE STE 200 STE 200 |
| City | NAMPA |
| State | ID |
| Zip Code | 83687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245493840 | Forrest R Fredline | Surgery | 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 | 2008-07-03 |
| 1013335157 | Wesley David Pidcock | Internal Medicine | 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 | 2014-04-05 |
| 1902154149 | Amber Taylor | Surgery | 4400 E Flamingo Ave Ste 200, Nampa, ID 83687-9203 | 2012-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307447 | Current Physical Therapy Nampa LLC | Physical Therapist | 16150 N High Desert Street, Nampa, ID 83687 | 2020-02-10 |
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1750828513 | Daniel & Max, LLC | Optometrist | 1600 Karcher Rd, Nampa, ID 83687 | 2017-01-31 |
| 1578965422 | Jorge Domingo Reyes | Counselor | 5700 E. Franklin Rd., Suite 220-i, Nampa, ID 83687 | 2014-09-23 |
| 1619302080 | David Lyle Farris | Dentist | 16548 North Franklin Blvd., Nampa, ID 83687 | 2013-09-04 |
| 1871934547 | Ian Zafar Qureshi | Internal Medicine | 4400 E Flamingo Ave Ste 130, Nampa, ID 83687 | 2013-07-10 |
| 1457696783 | Laurel Evans | Specialist/Technologist | 850 W. St. Luke's Dr., Suite 215, Nampa, ID 83687 | 2012-11-27 |
| 1750641197 | Andrea Patricia Fitzer | Nurse Practitioner | 4400 E. Flamingo Ave, Nampa, ID 83687 | 2012-05-18 |
| 1679846182 | Ivony Case Management | Case Management | 811 12th Street, Ste. 2, Nampa, ID 83687 | 2012-02-14 |
| 1699043679 | Saltzer Medical Group, P.a. | Durable Medical Equipment & Medical Supplies | 9850 W St Lukes Drive, Nampa, ID 83687 | 2011-12-06 |
| Find all providers in zip 83687 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1750839502 | Boyd Layton | Physician Assistant | 4424 E Flamingo Ave, Suite 110, Nampa, ID 83687-9289 | 2016-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218089 | Michael Keegan Huntsman | Physician Assistant | 730 Aspen Ave, Shelley, ID 83274-1400 | 2020-06-03 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1831647197 | Nicholas Hensley | Physician Assistant | 3155 Channing Way Ste B, Idaho Falls, ID 83404-7534 | 2016-09-15 |
| 1982937066 | Don H Curtis | Physician Assistant | 348 W Bloomington Dr, Meridian, ID 83642-6942 | 2009-09-08 |
| 1801073655 | Tracy D. Mickelsen | Physician Assistant | 3015 E Magic View Dr, Meridian, ID 83642-3743 | 2008-01-23 |
| 1356437172 | Clare Elizabeth York | Physician Assistant | 805 Main St., Salmon, ID 83467 | 2006-10-05 |
| 1891707618 | Brian Keith Lachapelle | Physician Assistant | 6140 W Curtisan, Ste 102, Boise, ID 83704 | 2006-08-12 |
| 1992743215 | Bill Stahlberg | Physician Assistant | 211 Forest St, Mccall, ID 83638-5256 | 2006-06-02 |
| 1780641530 | Alicia R Borst | Physician Assistant | 3960 W. Wainwright, Boise, ID 83713 | 2006-04-26 |
| 1275047409 | Alexx Sliman | Physician Assistant | 425 Idaho St, Gooding, ID 83330-1258 | 2017-11-27 |
| Find all providers with the same taxonomy | ||||
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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.