THERESA L. ROSS (NPI# 1891842563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891842563 |
| Entity Type | Individual |
| Full Name | THERESA L. ROSS |
| Credential | PHD |
| Practice Address |
777 Hospital Way Suite G11 Pocatello ID 83201-5175 |
| Practice Telephone | 2082391710 |
| Practice Fax Number | 2082391713 |
| Mailing Telephone | 2082391710 |
| Mailing Fax Number | 2082391713 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY202084 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807126900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235433533 | Theresa Joyce Ross | Nurse Practitioner | 6842 Plum Creek Dr, Amarillo, TX 79124-1601 | 2010-12-29 |
| 1689804445 | Theresa Marie Ross | Physical Therapist | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2009-07-15 |
| 1528072188 | Theresa J Ross | General Practice | 112 Saint John St, Monroe, LA 71201-7322 | 2006-07-28 |
| 1750355178 | Theresa Ann Ross | Registered Nurse | 11050 Mount Belvedere Blvd, Usa Meddac Attn Credentials, Fort Drum, NY 13602-5438 | 2006-02-14 |
| Street Address |
777 HOSPITAL WAY SUITE G11 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825892 | Gregory S Harrison | Neurological Surgery | 777 Hospital Way, Suite 115, Pocatello, ID 83201-5175 | 2005-07-15 |
| 1801401344 | Sunny Blue Alene Nelson | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-09-11 |
| 1316570757 | Mark Alan Pendleton | Nurse Anesthetist, Certified Registered | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-02-13 |
| 1508413220 | Hilary Worthen | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-08-19 |
| 1437612447 | Walter S Medlin Md PC | Surgery | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-04-08 |
| 1396203428 | Amber Frost | Family Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-03-07 |
| 1649756404 | Kamilla Gundersen | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83207 | 2018-07-16 |
| 1043716285 | Brice Anderson | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-04-05 |
| 1851808133 | Rocky Mountain Physician Group LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-08 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346890175 | Robert D Rieske | Psychologist | 921 S 8th Ave Stop 8112, Pocatello, ID 83209-8112 | 2019-09-13 |
| 1326191925 | Shannon M Lynch | Psychologist | Isu Psychology Clinic, Idaho State University, Stop 8112, Pocatello, ID 83209-0001 | 2007-01-19 |
| 1235689902 | Kathleen Rene Smith | Psychologist | 1000 N 8th Ave, Pocatello, ID 83201-5757 | 2016-10-06 |
| 1275983132 | Jabeene Bhimji | Psychologist | 500 S 11th Ave Ste 400, Pocatello, ID 83201-4880 | 2016-06-21 |
| 1639524895 | Elizabeth Craun | Psychologist | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2016-04-25 |
| 1154783538 | Healthwest | Psychologist | 1000 N 8th Ave, Pocatello, ID 83201-5757 | 2016-03-24 |
| 1598892143 | Peter Vik | Psychologist | Isu Psychology Clinic, Idaho State University Stop 8021, Pocatello, ID 83209-0001 | 2007-02-28 |
| 1124175898 | John L. Christensen | Psychologist | 500 S 11th Ave, Suite 302, Pocatello, ID 83201-4835 | 2007-01-04 |
| 1457408122 | Cynthia Lee Amen | Psychologist | 500 S 11th Ave, Suite 302, Pocatello, ID 83201-4835 | 2007-01-04 |
| 1972663839 | John Hanford Dickey | Psychologist | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2006-12-11 |
| Find all providers in POCATELLO | ||||
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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.