CHARLES E BOULT (NPI# 1962468025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962468025 |
| Entity Type | Individual |
| Full Name | CHARLES E BOULT |
| Credential | MD |
| Practice Address |
5966 W Curtisian Ave Boise ID 83706 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2083025400 |
| Practice Fax Number | 2083025455 |
| Mailing Telephone | 2083025400 |
| Mailing Fax Number | 2083025455 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
M-13173 | ID | Allopathic & Osteopathic Physicians |
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
D57945 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 687003100 | 05 |
| Street Address |
5966 W CURTISIAN AVE |
| City | BOISE |
| State | ID |
| Zip Code | 83706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730169178 | Laurie J Ashby | Family Medicine | 5966 W Curtisian Ave, Boise, ID 83604 | 2006-01-20 |
| 1376079004 | Jeremy Crowfoot | Pharmacist | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2017-05-01 |
| 1881129146 | Sara Jean Smith | Nurse Practitioner | 5966 W Curtisian Ave, Boise, ID 83704 | 2017-04-25 |
| 1447707120 | Sherri Siegel | Nurse Practitioner | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2016-09-09 |
| 1124498860 | Danielle Burke | Physician Assistant | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2015-10-06 |
| 1376938076 | Caitlin Kinahan | Internal Medicine | 5966 W Curtisian Ave, Boise, ID 83704 | 2015-03-31 |
| 1619234622 | Alexandra Nicole Meier | Internal Medicine | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2012-04-15 |
| 1174633085 | Kevin William Wilson | Internal Medicine | 5966 W Curtisian Ave, Boise, ID 83704 | 2006-08-30 |
| 1174598684 | Victor Bartling | Family Medicine | 5966 W Curtisian Ave, Boise, ID 83704 | 2006-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
| 1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| Find all providers in zip 83706 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1720187289 | Barry Justin Cusack | Internal Medicine | 500 West Fort St, (111), Boise, ID 83702-4598 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265621908 | On Site for Seniors Inc | Internal Medicine | 296 W Sunset Ave Ste 14, Coeur D Alene, ID 83815-8367 | 2007-10-18 |
Please comment or provide details below to improve the information on CHARLES E BOULT.
| 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.