SERGEY KASHUBIN (NPI# 1912569351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912569351 |
| Entity Type | Individual |
| Full Name | SERGEY KASHUBIN |
| Credential | NP-C |
| Practice Address |
10583 W Lake Hazel Rd Boise ID 83709-6326 |
| Mailing Address |
3340 E Goldstone Dr Meridian ID 83642 |
| Practice Telephone | 2083025950 |
| Mailing Telephone | 2083025900 |
| Mailing Fax Number | 2083025955 |
| Enumeration Date | 2019-07-06 |
| Last Update Date | 2019-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
56339 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
56339 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10583 W LAKE HAZEL RD |
| City | BOISE |
| State | ID |
| Zip Code | 83709-6326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275681256 | Daniel L Meltzer | Emergency Medicine | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2007-01-08 |
| 1255957403 | Alysse Michele Weber | Nurse Practitioner | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2020-06-23 |
| 1811522949 | Carmen Salyer | Nurse Practitioner | 10583 W Lake Hazel Rd, Boise, ID 83709-6326 | 2020-03-09 |
| 1760025142 | Cassandra Duncan | Nurse Practitioner | 10583 W Lake Hazel Rd, Boise, ID 83709-6326 | 2019-10-18 |
| 1013568468 | Micah Ray Tobin | Physician Assistant | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2019-09-26 |
| 1689226177 | Jeffrey Kenneth Weese | Nurse Practitioner | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2019-07-15 |
| 1184189839 | Eric Konkel | Physician Assistant | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2019-02-06 |
| 1851855258 | Cameron J Guthrie | Physician Assistant | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2019-01-30 |
| 1063983153 | Erin R Bohn | Nurse Practitioner | 10583 W Lake Hazel Rd, Boise, ID 83709-6326 | 2018-12-16 |
| 1457820334 | Tiffany S Millett | Nurse Practitioner | 10583 W Lake Hazel Rd, Boise, ID 83709-6326 | 2018-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655398 | Jayme Rossow | Occupational Therapist | 101 S. Allumbaugh Way, Boise, ID 83709 | 2020-10-05 |
| 1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
| 1164080164 | Elena Stamm | Audiologist | 10000 W Amity Rd, Boise, ID 83709 | 2019-06-04 |
| 1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
| 1457879975 | Mark Aaron Phelan | Registered Nurse | 779 S. Tennyson Way, Boise, ID 83709 | 2017-09-05 |
| 1235665290 | Sharon Nelson | Dietitian, Registered | 2790 S Goshen Way, Boise, ID 83709 | 2017-05-11 |
| 1982139622 | First Choice Healthcare, Inc. | Home Health | 12400 W. Overland Rd., Ste 100, Boise, ID 83709 | 2017-05-01 |
| 1801320254 | Deborah Carson | Social Worker | 8349 West Harmonica Way, Boise, ID 83709 | 2017-04-12 |
| 1114479862 | Allyson Anne Bates | Nurse Practitioner | 10583 W Lake Hazel Road, Samg Family Medicine, Boise, ID 83709 | 2016-10-28 |
| 1508221391 | Elisha L. Garrison | Counselor | 9196 W. Barnes Street, Boise, ID 83709 | 2015-12-21 |
| Find all providers in zip 83709 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295372308 | Elizabeth Balleweg | Nurse Practitioner | 2306 N 31st St, Boise, ID 83703-5628 | 2019-12-09 |
| 1821525452 | Kristin Meshelle Hofmann | Nurse Practitioner | 420 W Main St Ste 206, Boise, ID 83702-7363 | 2017-05-14 |
| 1992237648 | Candice Elaine Adams | Nurse Practitioner | 5108 N Maidstone Way, Boise, ID 83713-1367 | 2017-03-31 |
| 1073522082 | Melanie Ann Nash | Nurse Practitioner | Bvamc 500 Fort St, Boise, ID 83702 | 2006-08-07 |
| 1073123220 | Jemericus LLC | Nurse Practitioner | 800 W Main St Ste 1460, Boise, ID 83702-5983 | 2020-08-03 |
| 1477198190 | Ashley Cora Rose | Nurse Practitioner | 190 E Bannock St, Boise, ID 83712-6241 | 2019-11-18 |
| 1417389628 | James Ryan Farmer | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4501 | 2013-07-30 |
| 1730432352 | Jessica Lynn Butterfield | Nurse Practitioner | 1055 North Curtis Road, Boise, ID 83706-1309 | 2012-10-19 |
| 1689785172 | Nancy Elizabeth Witman | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4501 | 2006-08-31 |
| 1467420588 | Janet L Wood | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4501 | 2006-03-14 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on SERGEY KASHUBIN.
| 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.