DR. DAKOTA BREISH (NPI# 1811345374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811345374 |
| Entity Type | Individual |
| Full Name | DR. DAKOTA BREISH |
| Credential | M.D. |
| Practice Address |
90 Hope Dr Bldg 6000 Mountain Home Afb ID 83648-1062 |
| Mailing Address |
90 Hope Dr Bldg 600 Mountain Home Afb ID 83648-1057 |
| Practice Telephone | 2088287401 |
| Mailing Telephone | 2088287401 |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2019-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M-14006 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
90 HOPE DR BLDG 6000 |
| City | MOUNTAIN HOME AFB |
| State | ID |
| Zip Code | 83648-1062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023007846 | Craig Loyd Folsom | Dentist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2005-10-14 |
| 1598378614 | Whitney Mark Galloway | Physician Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2020-08-28 |
| 1457908360 | Le Ann Marie Egan | Psychologist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-26 |
| 1639725286 | Kadeesh Mcnaught | Dental Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-09 |
| 1982259875 | David J Emert | Dental Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-07 |
| 1568016103 | Dylan Broadwater | Pharmacist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-07-31 |
| 1700381175 | Erin Siebert | Military Health Care Provider | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2018-03-28 |
| 1538684915 | Emily Frieda Foxton | Physical Therapist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2017-08-07 |
| 1598298135 | Zack Hunter | Military Health Care Provider | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2017-04-11 |
| 1922456979 | Jakob Kamilow | Counselor | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851528392 | Amy Jo Glover | Military Health Care Provider | 90 Hope Dr. Bldg 6000, Mountain Home, ID 83648 | 2009-06-11 |
| 1306051065 | Thomas Michael Smith | Social Worker | 90 Hope Dr Bldg 1900, Mountain Home Afb, ID 83648 | 2007-05-14 |
| 1316005143 | Ronald Wesley Bailey | Radiology | Mountain Home Afb Medical Group, 90 Hope Drive, Building 6000, Mountain Home Afb, ID 83648 | 2006-12-05 |
| 1992780597 | Randall Jay Moore | Preventive Medicine | 366mdg/sgpf, 90 Hope Drive; Bldg 6000, Mountain Home Afb, ID 83648 | 2005-12-07 |
| 1356325666 | Joseph Carroll Skinner Jr. | Nurse Anesthetist, Certified Registered | 366 Mdos, Sgosa, 90 Hope Drive, Mountain Home Afb, ID 83648 | 2005-11-30 |
| 1477547271 | Ron Stumbo | Pharmacist | Mountain Home Afb, Mountain Home Afb, ID 83648 | 2005-09-07 |
| 1154315943 | Georgette Ann Trezvant | Social Worker | 366 Medical Operations Squadron, 90 Hope Drive, Bldg 6000, Mt. Home Air Force Base, ID 83648 | 2005-09-07 |
| 1265948897 | Alyse Marie Denittis | Physician Assistant | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-12-19 |
| 1891224473 | Jared Getzlaff | Military Health Care Provider | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-06-07 |
| 1548796527 | Derek J Dutson | Dentist | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-05-11 |
| Find all providers in zip 83648 | ||||
| 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 |
|---|---|---|---|---|
| 1790165116 | Andrew Ames | Family Medicine | 90 Hope Dr Bldg 6000, Flight Medicine, Mountain Home Afb, ID 83648-1062 | 2015-06-01 |
| 1578825501 | Matthew Christian Brown | Family Medicine | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2012-06-14 |
| 1881951903 | Michael Ryan Parks | Family Medicine | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2012-04-13 |
| 1275795270 | Hattie Mcaviney | Family Medicine | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2008-06-30 |
| 1336101633 | Troy M Schwartz | Family Medicine | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2006-04-04 |
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| 1699375659 | Jonathan Barrus Do PC | Family Medicine | 2020 S Johns Avenue, Emmett, ID 83617 | 2020-10-29 |
| 1750998126 | Story Family Medicine | Family Medicine | 1150 Alturas Dr Ste 101, Moscow, ID 83843-3263 | 2020-09-29 |
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1447880570 | Bore LLC | Family Medicine | 1498 Midway Ave Ste 2, Ammon, ID 83406-4587 | 2020-01-16 |
| 1669038220 | Savannah M Klinginsmith | Family Medicine | 17866 Polara Way, Nampa, ID 83687-9159 | 2019-05-18 |
| 1487218814 | Logan Perkins | Family Medicine | 132 5th Ave W Ste 2, Jerome, ID 83338-1825 | 2019-05-01 |
| 1588227656 | Traci H Permenter | Family Medicine | 943 N Linder Rd Ste 103, Kuna, ID 83634-3395 | 2019-04-15 |
| 1790244424 | Destin Thayne Bep Inc | Family Medicine | 859 S Yellowstone Hwy Ste 304, Rexburg, ID 83440-5294 | 2019-03-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME AFB |
| Zip Code | 83648 |
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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.