ANDREA D AXTELL (NPI# 1922298678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922298678 |
| Entity Type | Individual |
| Full Name | ANDREA D AXTELL |
| Other Name | ANDREA DAWN HALEY |
| Credential | MD |
| Practice Address |
520 S Eagle Rd Ste 3102 Meridian ID 83642-6351 |
| Mailing Address |
5995 W State St Ste A Boise ID 83703-3085 |
| Practice Telephone | 2087065100 |
| Practice Fax Number | 2087065169 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2017-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | M11047 | ID | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | LL17364 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437562584 | Andrea L Axtell | Surgery | Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 | 2014-06-06 |
| Street Address |
520 S EAGLE RD STE 3102 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-6351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356348015 | Robert E. Holland Jr. | Family Medicine | 520 S Eagle Rd, Ste 1241, Meridian, ID 83642-6351 | 2005-07-07 |
| 1659984284 | Heather R Zimmerman | Occupational Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-24 |
| 1619587573 | Maria Herbison | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-05 |
| 1952927543 | Grayson T Kendall | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-19 |
| 1891310371 | David Joseph Matthews | Respiratory Therapist, Registered | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-10 |
| 1356960603 | Rebecca Finder | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-04-15 |
| 1982231023 | Stephen Blake Miltner | Physical Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-26 |
| 1093342834 | Clayton Hawks | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-23 |
| 1912547647 | Emily Tyler Getlein Marques | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-01-10 |
| 1184264244 | Jordan Leach | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642 | 2020-01-07 |
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| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1003278730 | Tyler T Birch | Internal Medicine | 520 S Eagle Rd Ste 3102, Meridian, ID 83642-6352 | 2016-03-22 |
| 1932459997 | Thomas L Lucky | Internal Medicine | 1216 Constitution Ave, Meridian, MS 39301-4003 | 2012-09-17 |
| 1720342777 | Spencer Miller | Internal Medicine | 3525 E Louise Drive Suite 400, Meridian, ID 83642-6303 | 2012-06-25 |
| 1891086021 | Byron Elliott Brown | Internal Medicine | 7019 N Penncross Way, Meridian, ID 83646-5185 | 2011-04-21 |
| 1306086541 | Kristi Warren Durgin | Internal Medicine | 1800 45th Ct, Meridian, MS 39305-2733 | 2009-02-28 |
| 1912147240 | Edward G. Scott Jr. | Internal Medicine | 4714 11th Pl, Meridian, MS 39305-2768 | 2009-02-26 |
| 1285851337 | Frederick M Costello | Internal Medicine | 520 S. Eagle Rd, Ste 3104, Meridian, ID 83642 | 2007-04-19 |
| 1396833398 | Olugboyega O Ransome-kuti | Internal Medicine | 2701 Davis Street, Meridian, MS 39301-5708 | 2006-10-11 |
| 1518077437 | James H Gallafent | Internal Medicine | 520 S. Eagle Road, Suite #3102, Meridian, ID 83642 | 2006-08-30 |
| 1497797302 | Ann C Agnew | Internal Medicine | 3080 E Gentry Way Ste 210, Meridian, ID 83642-3013 | 2006-06-12 |
| Find all providers in MERIDIAN | ||||
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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.