THADEUS B KOONTZ (NPI# 1609010156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609010156 |
| Entity Type | Individual |
| Full Name | THADEUS B KOONTZ |
| Credential | MD |
| Practice Address |
428 6th Ave Lewiston ID 83501-2355 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2087507462 |
| Mailing Telephone | 2083672175 |
| Mailing Fax Number | 2083760285 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2019-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
M-11984 | ID | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
M11984 | ID | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 131 N Allumbaugh St, Boise, ID 837049204 | 2083672175 | 2083760285 |
| Street Address |
428 6TH AVE |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205858289 | Lynn-marie Morgan Peashka | Nurse Practitioner | 428 6th Ave, Lewiston, ID 83501-2355 | 2006-07-25 |
| 1043753742 | Larry Bearden | Counselor | 428 6th Ave, Lewiston, ID 83501-2355 | 2016-11-29 |
| 1619328044 | Amy Kelley | Social Worker | 428 6th Ave, Lewiston, ID 83501-2355 | 2016-06-27 |
| 1649629700 | Pamela Jean Wieters | Social Worker | 428 6th Ave, Lewiston, ID 83501-2355 | 2016-06-09 |
| 1730541467 | Karen Simmons | Counselor | 428 6th Ave, Lewiston, ID 83501-2355 | 2016-03-22 |
| 1922476845 | Alison Lawhead | Social Worker | 428 6th Ave, Lewiston, ID 83501-2355 | 2015-09-09 |
| 1003284126 | St. Joseph's Regional Medical Center | General Acute Care Hospital | 428 6th Ave, Lewiston, ID 83501-2355 | 2015-09-05 |
| 1013313667 | Katherine Ann Troutman | Counselor | 428 6th Ave, Lewiston, ID 83501-2355 | 2014-11-10 |
| 1619241387 | Betty J Weeks | Counselor | 428 6th Ave, Lewiston, ID 83501-2355 | 2012-02-28 |
| 1235398017 | Chivonne Marie Mraz | Social Worker | 428 6th Ave, Lewiston, ID 83501-2355 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063566925 | Paula Claire Kirby-long | Psychiatry & Neurology | 76 High St Ste 300, Lewiston, ME 04240-7591 | 2007-01-22 |
| 1518928613 | Brigitte M Hristea | Psychiatry & Neurology | 100 Campus Avenue, Suite 208, Lewiston, ME 04240 | 2006-03-29 |
| 1619949526 | Henry C. Skinner | Psychiatry & Neurology | 1155 Lisbon St, Lewiston, ME 04240-5025 | 2006-02-03 |
| 1225028814 | Ira M. Shapiro | Psychiatry & Neurology | 100 Campus Ave, Suite 208, Lewiston, ME 04240-6040 | 2005-10-25 |
| 1275535866 | Brent Joseph Landkammer | Psychiatry & Neurology | 450 Thain Rd Ste F, Lewiston, ID 83501-5300 | 2005-08-12 |
| 1972156297 | Canyonview Family Psychiatry, Pllp | Psychiatry & Neurology | 450 Thain Rd Ste F, Lewiston, ID 83501-5300 | 2019-07-17 |
| 1215324694 | Annabel L Bradford | Psychiatry & Neurology | 93 Campus Ave, Lewiston, ME 04240-6030 | 2015-04-23 |
| 1093007304 | Lori Beth Bennett-penn | Psychiatry & Neurology | 415 6th St, Lewiston, ID 83501-2434 | 2011-05-04 |
| 1508186594 | Noreen M Flanagan | Psychiatry & Neurology | 93 Campus Ave, Lewiston, ME 04240 | 2010-06-02 |
| 1922233071 | Dylan M Mckenney | Psychiatry & Neurology | 93 Campus Ave, Lewiston, ME 04240-6030 | 2009-05-19 |
| Find all providers in LEWISTON | ||||
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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.