DR. RICHARD EMERY LALLY (NPI# 1750489647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750489647 |
Entity Type | Individual |
Full Name | DR. RICHARD EMERY LALLY |
Credential | M.D. |
Practice Address |
709 N Lincoln Ave Jerome ID 83338-1851 |
Mailing Address |
11020 W Amity Rd Boise ID 83709-5051 |
Practice Telephone | 2083244301 |
Practice Fax Number | 2083242224 |
Mailing Telephone | 2085621664 |
Mailing Fax Number | 2085621565 |
Enumeration Date | 2006-09-21 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
M8141 | ID | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407964067 | Richard A. Lally | Counselor | 5425 Golden Eagle Court, Wilmington, NC 28409 | 2006-08-25 |
Street Address |
709 N LINCOLN AVE |
City | JEROME |
State | ID |
Zip Code | 83338-1851 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336138783 | Brian Lee Johnson | Family Medicine | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2005-10-18 |
1609414051 | Troy M Jackman | Pharmacist | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2019-12-17 |
1891165569 | Anne B Fullmer | Nurse Practitioner | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2015-10-06 |
1366874877 | St Luke's Magic Valley Regional Medical Center Ltd | General Acute Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2013-08-07 |
1730511254 | St Lukes Magic Valley Regional Medical Center Ltd | Medicare Defined Swing Bed Unit | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2013-08-07 |
1912137175 | Paul A Dickinson | Nurse Anesthetist, Certified Registered | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2009-07-22 |
1700053774 | St Benedicts Fmc Physician Assistants | Physician Assistant | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2008-05-09 |
1083833933 | Thomas Henry Zepeda | Personal Emergency Response Attendant | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-04-25 |
1639211634 | St. Benedicts Family Medical Center | Long Term Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-02-13 |
1902856727 | St Benedicts Family Medical Center | Skilled Nursing Facility | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2006-05-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
1811391626 | Summit Therapy Services | In Home Supportive Care | 113 East Ave. F, Jerome, ID 83338 | 2014-10-22 |
1952645285 | Readings Community Pharmacy Inc | Pharmacy | 133 West A, Jerome, ID 83338 | 2012-11-27 |
1801121298 | Yolanda S. Sedano | Physician Assistant | 132 5th Ave West, Jerome, ID 83338 | 2009-10-02 |
1295898310 | Ronald Gail Hendrickson | Dentist | 128 South Adams, Jerome, ID 83338 | 2006-12-19 |
1316035512 | Johnson Chiropractic Clinic | Chiropractor | 600 N Lincoln Ave, Jerome, ID 83338 | 2006-10-11 |
1265527725 | Lon M. Egbert, P.C. | Specialist/Technologist | 128 5th Ave West, Jerome, ID 83338 | 2006-10-03 |
1992898605 | St Benedicts Family Medical Center | Home Health | 414 N Lincoln, Suite 1, Jerome, ID 83338 | 2006-10-02 |
1790231355 | Lexa Marie Balling | Pharmacist | 2680 S Lincoln Ave, Jerome, ID 83338 | 2016-09-01 |
1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
Find all providers in zip 83338 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538516471 | Anthony Christopher Derrico | Emergency Medicine | 366 Gunfighter Ave Ste 498, Mountain Home Afb, ID 83648-5258 | 2016-05-20 |
1881752913 | Richard K Thurston | Emergency Medicine | 229 S 7th Street, St Maries, ID 83861 | 2006-12-04 |
1255399820 | Warren William Gude | Emergency Medicine | 600 Robbins Road, The Center for Wound Healing and Hyperbaric Medicine, Boise, ID 83702 | 2006-05-03 |
1821529918 | Jonathan Subaitani | Emergency Medicine | 11197 W Fairview Ave, Boise, ID 83713 | 2017-03-21 |
1841679669 | Robert John Hagenberg IIi | Emergency Medicine | 3080 E Gentry Way Ste 210, Meridian, ID 83642 | 2015-05-26 |
1194019406 | Michael Anderson | Emergency Medicine | 450 E Main St, Rexburg, ID 83440-2048 | 2011-06-03 |
1508003104 | Rocky Mountain Emergency Physicians, LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201 | 2009-01-19 |
1225201148 | Rodney Gillman Jay Jr. | Emergency Medicine | 450 E Main St, Rexburg, ID 83440-2048 | 2008-04-11 |
1720114275 | North Idaho Immediate Care | Emergency Medicine | 750 N Syringa St, Suite 100, Post Falls, ID 83854-5275 | 2007-02-26 |
1407903669 | Debra K Mckinnon | Emergency Medicine | 700 S Main St, Moscow, ID 83843-3056 | 2007-01-03 |
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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.