MICHAEL DAVID SCHICKER (NPI# 1861774291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861774291 |
| Entity Type | Individual |
| Full Name | MICHAEL DAVID SCHICKER |
| Credential | DO |
| Practice Address |
30544 Highway 200 Ste 102 Ponderay ID 83852 |
| Mailing Address |
30544 Highway 200 Ste 102 Ponderay ID 83852-5005 |
| Practice Telephone | 2082659817 |
| Mailing Telephone | 2082659817 |
| Mailing Fax Number | 5305418723 |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2019-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
OP60637340 | WA | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
O0947 | ID | Allopathic & Osteopathic Physicians |
| N | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
OP60637340 | WA | Allopathic & Osteopathic Physicians |
| N | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
O0947 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8502734 | 05 | |
| ID | 807920700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 714 W Pine St, Newport, WA 991569046 | 5094472441 | 5094472281 |
| Street Address |
30544 HIGHWAY 200 STE 102 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| 1780651539 | Bruce William Demko | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2006-03-01 |
| 1679110845 | Angela Alice Chapin | Massage Therapist | 30544 Highway 200, Ponderay, ID 83852-5005 | 2019-12-05 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399517 | Delaney Bergen | Orthopaedic Surgery | 738 N College Rd Ste C, Twin Falls, ID 83301-3387 | 2020-08-31 |
| 1164597431 | Douglas Alan Cipriano | Orthopaedic Surgery | 606 N. 3rd Avenue, Suite 201, Sandpoint, ID 83864-1689 | 2006-11-22 |
| 1558375568 | Joseph R Liljenquist | Orthopaedic Surgery | 3405 Merlin Drive, Idaho Falls, ID 83404 | 2006-07-27 |
| 1124061163 | Sun Valley Sports Medicine, P.a. | Orthopaedic Surgery | 191 5th St W, Ketchum, ID 83340 | 2006-06-14 |
| 1568443158 | Paul Calvin Collins | Orthopaedic Surgery | 3875 E Overland Rd, Meridian, ID 83642-9005 | 2005-11-10 |
| 1063418903 | George A. Wade | Orthopaedic Surgery | 1188 University Dr, Boise, ID 83706-3009 | 2005-06-24 |
| 1306842182 | Michael J Gustavel | Orthopaedic Surgery | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2005-06-24 |
| 1861961732 | Gustavel Orthopedics Pllc | Orthopaedic Surgery | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2018-11-20 |
| 1114445087 | Bmh Inc. | Orthopaedic Surgery | 560 Memorial Dr, Pocatello, ID 83201-4070 | 2017-08-31 |
| 1982060984 | Bonner General Hospital, Inc | Orthopaedic Surgery | 606 N 3rd Ave, Ste 201, Sandpoint, ID 83864-1594 | 2016-01-06 |
| 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.