JOHN CHRISTOPHER STACKOW (NPI# 1922095397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922095397 |
| Entity Type | Individual |
| Full Name | JOHN CHRISTOPHER STACKOW |
| Credential | MD |
| Practice Address |
229 S 8th St St Maries ID 83861-1813 |
| Practice Telephone | 2082452591 |
| Practice Fax Number | 2082455246 |
| Mailing Telephone | 2082452591 |
| Mailing Fax Number | 2082455246 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | M6239 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF ID | 12393 | 01 |
| WA | DEPT OF LABOR AND INDUSTR | 43646 | 01 |
| ID | REGENCE BS OF ID | 000010005293 | 01 |
| WA | 8434888 | 05 |
| Street Address |
229 S 8TH ST |
| City | ST MARIES |
| State | ID |
| Zip Code | 83861-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974191 | Terry Evert Davenport | Family Medicine | 229 S 8th St, St Maries Family Medicine, St Maries, ID 83861-1813 | 2005-09-30 |
| 1952775702 | Rise Kevalshar Collins | Social Worker | 229 S 8th St, St Maries, ID 83861-1813 | 2015-11-17 |
| 1114996428 | Karen D Libsch | Family Medicine | 229 S 8th St, St Maries, ID 83861-1813 | 2006-03-17 |
| 1386632180 | Benewah Community Hospital | General Practice | 229 S 8th St, St Maries, ID 83861-1813 | 2005-10-06 |
| 1043207418 | John Michael Mcnulty | Orthopaedic Surgery | 229 S 8th St, St Maries Family Medicine, St Maries, ID 83861-1813 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659880789 | Catherine Frances Bean | Private Vehicle | 5753 Alder Creek Rd, St. Maries, ID 83861 | 2017-09-20 |
| 1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
| 1881752913 | Richard K Thurston | Emergency Medicine | 229 S 7th Street, St Maries, ID 83861 | 2006-12-04 |
| 1851337208 | Robert D Magwire | Optometrist | 704 College, St Maries, ID 83861 | 2006-06-22 |
| 1205810025 | William Walter Wheeler | Surgery | 229 S. 7th Street, St. Maries, ID 83861 | 2005-12-05 |
| 1952469082 | John Richard Katovich Jr. | Emergency Medicine | 229 S 7th Street, St Maries, ID 83861 | 2006-12-04 |
| 1255351458 | William Scott Spence | Family Medicine | 229 S. 7th Street, St. Maries, ID 83861 | 2006-07-20 |
| 1992756233 | Terry L Spohr | Physician Assistant | 229 S. 7th Street, St. Maries, ID 83861 | 2006-05-12 |
| 1699723411 | David James Luther | Family Medicine | 229 S. 7th Street, Saint Maries, ID 83861 | 2006-05-04 |
| 1629627666 | Valerie Kay Sanchez | Technician/Technologist | 305 N 19th St, St Maries, ID 83861-1156 | 2019-09-11 |
| Find all providers in zip 83861 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790340834 | Idaho Surgical, LLC | Surgery | 6195 E Hunt Ave, Nampa, ID 83687-8317 | 2019-05-03 |
| 1982178596 | Huntington Laparoscopy, PC | Surgery | 222 N 2nd St Ste 107, Boise, ID 83702-6129 | 2019-01-16 |
| 1508350331 | Matthew Jacobsson | Surgery | 2920 N High Desert Way, Meridian, ID 83646-9066 | 2018-06-15 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| 1326385410 | Robert Henry Morrell | Surgery | 2061 S Springbrook Ln, Boise, ID 83706 | 2013-01-09 |
| 1992040356 | Sandpoint Surgical Associates | Surgery | 502 N Second Ave, Suite 3, Sandpoint, ID 83864-1558 | 2012-12-11 |
| 1063774727 | Ciara Rosemary Huntington | Surgery | 222 North 2nd Street, Suite 107, Boise, ID 83702 | 2012-06-08 |
| 1093086589 | Robert Sumner West | Surgery | 3621 W Fairway Dr, Coeur D Alene, ID 83815-9049 | 2012-01-16 |
| 1790012383 | Brian E O'byrne, M.d. P.a. | Surgery | 2860 Channing Way Ste 117, Idaho Falls, ID 83404-7532 | 2009-11-03 |
| 1679716591 | Daniel Paul Gay | Surgery | 404 Elm Street, Caldwell, ID 83605 | 2009-04-07 |
| 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.