PREVENTATIVE HEALTH (NPI# 1922377027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922377027 |
| Entity Type | Organization |
| Organization Name | PREVENTATIVE HEALTH |
| Practice Address |
531 S Fitness Pl Ste 100 Eagle ID 83616-6552 |
| Mailing Address |
531 S Fitness Pl 100 Eagle ID 83616-6552 |
| Practice Telephone | 2088532273 |
| Mailing Telephone | 2088532273 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | DANIELLE BENNION (OWNER) |
| Authorized Official Telephone | 2088532273 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PREVENTATIVE HEALTH CONSULTANTS, INC | 9836 42 Sw, Seattle, WA 98136 |
| Oregon Corporations, Companies and Business Names | PREVENTATIVE HEALTH LLC | 531 S Fitness Place Suite 100, Suite 100, Eagle, ID 83616 |
| Colorado Business Entities | Preventative Health On The Go LLC | 12445 E 39th Ave, Build C Suite 301, Denver, CO 80239 |
| New York State Corporations | PREVENTATIVE HEALTHCARE SOLUTIONS, LLC | 2 Southgate Circle, Massapequa Park, New York 11762 |
| Street Address |
531 S FITNESS PL STE 100 |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-6552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760003438 | Megan Bauscher | Nurse Practitioner | 3426 S Sugar Loaf Pl, Eagle, ID 83616-6751 | 2020-05-04 |
| 1174169254 | Scot Klein | Nurse Practitioner | 3188 W Wind Ct, Eagle, ID 83616-4692 | 2019-11-22 |
| 1437661345 | Benjamin Prinzing | Nurse Practitioner | 951 E Plaza Dr Ste 110, Eagle, ID 83616-6567 | 2017-11-01 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| 1306166905 | Courtney Nicole Flynn | Nurse Practitioner | 379 E Shore Dr Ste 100, Eagle, ID 83616-5410 | 2010-06-04 |
| 1386643146 | Cynthia Ray Culp | Nurse Practitioner | 951 E Plaza Dr, Suite Number 110, Eagle, ID 83616-6566 | 2005-07-14 |
| 1215936034 | Heather Nicole Knutson | Nurse Practitioner | 1605 E Riverside Drive, Eagle, ID 83616-6237 | 2005-07-14 |
| 1013915164 | Beth Elaine Landis | Nurse Practitioner | 1540 E Rivers End Ct, Eagle, ID 83616-6390 | 2005-07-12 |
| 1376188698 | Mason Carter | Nurse Practitioner | 21 N Fisher Park Way, Eagle, ID 83616-4796 | 2019-11-11 |
| 1952852642 | Kami Crnich Bellomy | Nurse Practitioner | 1159 E Iron Eagle Dr, Suite 170d, Eagle, ID 83616-6871 | 2016-10-18 |
| Find all providers in EAGLE | ||||
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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.