IDAHO UROLOGIC INSTITUTE PA (NPI# 1689620692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689620692 |
| Entity Type | Organization |
| Organization Name | IDAHO UROLOGIC INSTITUTE PA |
| Practice Address |
2855 E Magic View Dr Meridian ID 83642-6245 |
| Practice Telephone | 2086394900 |
| Practice Fax Number | 2086394939 |
| Mailing Telephone | 2086394900 |
| Mailing Fax Number | 2086394939 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-10-18 |
| Authorized Official Name | DR. TODD WALDAMANN (MANAGER) |
| Authorized Official Telephone | 2083437736 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD MERIDIAN | 000010006729 | 01 |
| ID | BLUE CROSS MERIDIAN | 8M879 | 01 |
| ID | RAILROAD MEDICARE | DD7372 | 01 |
| ID | BLUE CROSS NAMPA | 8M783 | 01 |
| ID | BLUE CROSS BOISE | 8M152 | 01 |
| ID | BLUE SHIELD BOISE | 000010152026 | 01 |
| ID | BLUE SHIELD NAMPA | 000010152026 | 01 |
| Street Address |
2855 E MAGIC VIEW DR |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-6245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023013109 | Eric W Klein | Specialist | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2005-06-16 |
| 1174156418 | Lea Jo Piper | Urology | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2020-02-14 |
| 1316587751 | Samuel Merritt Uebelacker | Physician Assistant | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2020-01-14 |
| 1598231623 | Katherine Lindsay Mondada | Physician Assistant | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2018-10-16 |
| 1316331705 | Adam Schatz | Urology | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2015-03-24 |
| 1053695676 | Melissa Brianne Mcclenahan | Physician Assistant | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2011-09-30 |
| 1659663482 | Lisa Michela Parrillo | Urology | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2011-05-12 |
| 1942356647 | Heather R Crandall | Specialist/Technologist, Other | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2007-01-26 |
| 1427143346 | Katy Holder | Physician Assistant | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2006-10-04 |
| 1265478374 | Stephanie Brooke Hodson | Internal Medicine | 2855 E Magic View Dr, Meridian, ID 83642 | 2006-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699242123 | Treasure Valley Urology Pllc | Urology | 3090 E Gentry Way Ste 220, Meridian, ID 83642-3550 | 2018-11-02 |
| 1346407921 | Helen Jia-ru Kuo | Urology | 2855 E. Magic View Drive, Meridian, ID 83642 | 2008-05-21 |
| 1912088295 | Urology Clinic of Meridian, P.a. | Urology | 1302 20th Ave, Meridian, MS 39301-4120 | 2006-10-17 |
| 1710097068 | Jared G Heiner | Urology | 3085 E Magic View Dr Ste 140, Meridian, ID 83642-3745 | 2006-08-30 |
| 1174156418 | Lea Jo Piper | Urology | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2020-02-14 |
| 1316331705 | Adam Schatz | Urology | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2015-03-24 |
| 1083025951 | Andrew Gowdey | Urology | 1800 12th St, Meridian, MS 39301-4158 | 2014-05-14 |
| 1659663482 | Lisa Michela Parrillo | Urology | 2855 E Magic View Dr, Meridian, ID 83642-6245 | 2011-05-12 |
| 1831497940 | Anderson Physician Alliance, Inc | Urology | 1302 20th Ave, Meridian, MS 39301-4120 | 2011-03-14 |
| 1689828162 | Michael B. Taylor | Urology | 520 S Eagle Rd, Suite 3112, Meridian, ID 83642-6351 | 2008-11-10 |
| Find all providers in MERIDIAN | ||||
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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.