CATALYST MEDICAL GROUP, PLLC (NPI# 1609940501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609940501 |
| Entity Type | Organization |
| Organization Name | CATALYST MEDICAL GROUP, PLLC |
| Other Organization Name | MOSCOW FAMILY MEDICINE, PA |
| Practice Address |
623 S Main St Moscow ID 83843-2983 |
| Practice Telephone | 2088822011 |
| Practice Fax Number | 2088831853 |
| Mailing Telephone | 2088822011 |
| Mailing Fax Number | 2088831853 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2016-11-29 |
| Authorized Official Name | JEFFREY E GEIER (CEO) |
| Authorized Official Telephone | 2088822011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805220900 | 05 | |
| ID | 002399300 | 05 |
| Other Name | Type Code |
|---|---|
| Moscow Family Medicine, PA | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023545373 | Catalyst Medical Group, Pllc | Durable Medical Equipment & Medical Supplies | 320 Warner Dr, Lewiston, ID 83501 | 2017-05-17 |
| 1871033266 | Catalyst Medical Group, Pllc | Durable Medical Equipment & Medical Supplies | 2315 8th St, Lewiston, ID 83501 | 2017-03-03 |
| 1912458787 | Catalyst Medical Group, Pllc | Clinic/Center | 2315 8th St, Lewiston, ID 83501 | 2016-10-17 |
| Street Address |
623 S MAIN ST |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-2983 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053398578 | Patricia N. Marciano | Family Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2005-12-27 |
| 1639482409 | Providence Health & Services | Internal Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2010-07-21 |
| 1730254285 | Jay T Thiemann | Specialist/Technologist, Other | 623 S Main St, Suite 6, Moscow, ID 83843-2983 | 2006-11-21 |
| 1891732319 | Nancy Jo Elsbury | Family Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2006-06-01 |
| 1104890177 | Helen Marie Shearer | Family Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2006-02-15 |
| 1811961881 | Steven Eugene Fischer | Physician Assistant | 623 S Main St, Moscow, ID 83843-2983 | 2006-02-15 |
| 1871567909 | Gloria Workman | Nurse Practitioner | 623 S Main St, Moscow, ID 83843-2983 | 2006-02-15 |
| 1770557662 | William E Caldwell | Emergency Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2006-02-15 |
| 1013981604 | Glenn David Rych | Family Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2006-02-13 |
| 1285607085 | Wayne Lavern Ruby | Family Medicine | 623 S Main St, Moscow, ID 83843-2983 | 2006-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1346799483 | Healing Sanctuary LLC | Clinic/Center | 187 E 13th St, Idaho Falls, ID 83404-5305 | 2016-09-30 |
| 1760741334 | Saint Alphonsus Regional Medical Center Inc | Clinic/Center | 131 Constitution Way, Nampa, ID 83686 | 2012-05-16 |
| 1750681607 | Family Services, Pllc | Clinic/Center | 501 N 16th St Ste 108, Payette, ID 83661-2782 | 2010-10-26 |
| 1043545106 | Ashwood Recovery LLC. | Clinic/Center | 7941 W Rifleman St, Boise, ID 83704-9001 | 2009-10-07 |
| 1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
| 1659371870 | Saint Alphonsus Medical Center Nampa, Inc. | Clinic/Center | 4300 E Flamingo Ave, Nampa, ID 83687-3138 | 2005-07-29 |
| 1881200517 | Vannvei LLC | Clinic/Center | 1522 17th St, Lewiston, ID 83501-3652 | 2020-09-18 |
| 1831716182 | Regenesis Health Centre Inc. | Clinic/Center | 430 W Iowa Ave Ste A, Nampa, ID 83686-2826 | 2020-07-02 |
| 1568005809 | Pure Healthcare of Idaho LLC | Clinic/Center | 6560 W Emerald St Ste 122, Boise, ID 83704-8781 | 2019-10-18 |
| 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.