ENNIS ENDOCRINOLOGY, PLLC (NPI# 1902143134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902143134 |
| Entity Type | Organization |
| Organization Name | ENNIS ENDOCRINOLOGY, PLLC |
| Practice Address |
2450 E Gala St Ste 100 Meridian ID 83642-4805 |
| Mailing Address |
2498 W Timber Dr Eagle ID 83616-4665 |
| Practice Telephone | 2089948180 |
| Practice Fax Number | 2089084542 |
| Mailing Telephone | 2089948180 |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2020-04-09 |
| Authorized Official Name | DR. ROBERT FRANK ENNIS (PHYSICIAN) |
| Authorized Official Telephone | 2089948180 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
M-11309 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
2450 E GALA ST STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-4805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679968051 | Michael Dee Holyoak | Internal Medicine | 520 S Eagle Rd Ste 1234, Meridian, ID 83642-6355 | 2015-04-01 |
| 1366647729 | Robert F. Ennis | Internal Medicine | 1626 Wells Ave, Suite 105, Meridian, ID 83642-4524 | 2007-06-18 |
| 1366498677 | Linda Mary Dales | Internal Medicine | 1516 23rd Ave, Meridian, MS 39301-4026 | 2006-05-26 |
| 1003881970 | Lynn Ge-zerbe | Internal Medicine | 1759 S Millenium Way, Meridian, ID 83642-1505 | 2006-02-22 |
| 1275796757 | Urseline A. Hawkins | Internal Medicine | 1516 23rd Ave, Meridian, MS 39301-4026 | 2008-07-06 |
| 1477530335 | Johannes D Veldhuis | Internal Medicine | 520 S Eagle Rd, Suite 1234, Meridian, ID 83642-6351 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144783499 | Mountain States Diabetes Relief, LLC | Internal Medicine | 4573 E Majestic, Idaho Falls, ID 83406 | 2019-04-12 |
| 1720068760 | Irinel N Stanciu | Internal Medicine | 403 S 11th St, Ste 100, Boise, ID 83702-6969 | 2006-01-17 |
| 1619977600 | John E Liljenquist | Internal Medicine | 2220 E 25th St, Idaho Falls, ID 83404-7542 | 2005-07-30 |
| 1437159423 | Carl D Vance | Internal Medicine | 3910 Washington Pkwy, Idaho Falls, ID 83404-7596 | 2005-07-30 |
| 1285142943 | Selkirk Endocrinology, Pllc | Internal Medicine | 1125 E Polston Ave Ste B, Post Falls, ID 83854-6045 | 2018-01-16 |
| 1801113329 | St Luke's Regional Medical Center | Internal Medicine | 403 S 11th St, Ste 100, Boise, ID 83702-6969 | 2010-04-23 |
| 1518165984 | Idaho Endocrinology, Pllc | Internal Medicine | 403 S 11th St, Suite 100, Boise, ID 83702-6968 | 2007-07-06 |
| 1659414399 | Richard B. Christensen, M.d. | Internal Medicine | 403 S 11th St, Suite 100, Boise, ID 83702-6968 | 2007-02-14 |
| 1255489746 | Gihan E. Dawood | Internal Medicine | 403 S 11th St, Suite 100, Boise, ID 83702-6969 | 2007-01-08 |
| 1336220243 | Rocky Mountain Diabetes and Osteoporosis Center Pa | Internal Medicine | 3910 Washington Pkwy, Idaho Falls, ID 83404-7596 | 2006-10-18 |
| 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.