DR. DEREK B HAMBLIN (NPI# 1790713204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790713204 |
| Entity Type | Individual |
| Full Name | DR. DEREK B HAMBLIN |
| Credential | M.D. |
| Practice Address |
4815 Cleveland Blvd Caldwell ID 83605-6501 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2084553545 |
| Mailing Telephone | 2089556500 |
| Mailing Fax Number | 2089556503 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD23651 | OR | Other Service Providers |
| Y | 207Q00000X | Family Medicine | M-11020 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE RAILROAD | P00479099 | 01 |
| Street Address |
4815 CLEVELAND BLVD |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710537964 | Donald E Sanford Jr. | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2019-09-18 |
| 1174038798 | Andrew Don Mcmurray | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2017-12-05 |
| 1689191140 | Delores Maybach | Nurse Practitioner | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2017-08-25 |
| 1174980346 | Ryan Wilson | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2016-01-19 |
| 1538565270 | Joshua Keith Wilding | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2014-11-07 |
| 1972905453 | Paddy Downey | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2014-09-16 |
| 1801089255 | Robert H Duff | Nurse Practitioner | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2007-08-20 |
| 1245321942 | Daryn J. Barnes | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902143126 | Idaho Behavioral Health, Inc. | Family Medicine | 524 S 9th Ave, #101, Caldwell, ID 83605-5075 | 2013-01-08 |
| 1104089556 | J'cinda J'nae Bitters | Family Medicine | 211 E Logan St Ste 301, Caldwell, ID 83605-4882 | 2008-07-07 |
| 1467631598 | Del B. Stigler M.d. | Family Medicine | 302 Highway 21 West, Caldwell, TX 77836-0000 | 2007-10-25 |
| 1679648836 | Del Barker Stigler | Family Medicine | 302 W Highway 21, Caldwell, TX 77836-1122 | 2006-11-22 |
| 1346252855 | Robert A Spencer | Family Medicine | 304 Main Street, Caldwell Clinic, Caldwell, OH 43724-1396 | 2006-08-13 |
| 1396760385 | Travis Lee Page | Family Medicine | 2523 S 10th Ave Ste 103, Caldwell, ID 83605-6760 | 2006-07-12 |
| 1013945070 | John Scott Chennault | Family Medicine | 1010 Woodson Dr, Caldwell, TX 77836-1000 | 2006-06-29 |
| 1720022239 | Patrick D Stowell | Family Medicine | 512 N 21st Ave, Caldwell, ID 83605-4368 | 2006-06-15 |
| 1306880844 | John R Pearce | Family Medicine | 1825 S Kimball Ave, Caldwell, ID 83605-4828 | 2006-06-15 |
| 1891740643 | Premier Family Medical, PC | Family Medicine | 110 Bloomfield Ave, Caldwell, NJ 07006-5336 | 2006-05-23 |
| Find all providers in CALDWELL | ||||
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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.