Braton P Fredline (NPI# 1740733401, PAC ID# 2264710979) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1740733401 |
| PAC ID by PECOS | 2264710979 |
| Professional Enrollment ID | I20190208000353 |
| Full Name | Braton P Fredline |
| Organization Legal Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Address |
3950 17th St Baker City OR 97814-1300 |
| Phone Number | 5415231001 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4981878402 |
| Number of Group Practice Members | 770 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 381315 | ST. ALPHONSUS MEDICAL CENTER - BAKER CITY |
| Address | Phone | Organization |
|---|---|---|
| 3445 Pocahontas Rd, Baker City, OR 97814-3599 | 5415231001 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| 3950 17th St, Baker City, OR 97814-1300 | 5415231001 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Organization Legal Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Physicians | 831 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Scholten | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Tracye J Lawyer | Orthopedic Surgery | St Lukes Clinic-treasure Valley LLC | 9850 St Lukes Dr, Suite 215, Nampa, ID 83687-7912 |
| Alex Mari Tanabe | Internal Medicine | St Lukes Clinic-treasure Valley LLC | 600 N Robbins Rd, Boise, ID 83702-4565 |
| Jessica J Carpenter | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 1620 S Kimball Ave, Caldwell, ID 83605-4547 |
| Whitney B Conrad | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 1226 W River St, Boise, ID 83702-7049 |
| Megan D Larson | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 287 W Jefferson St, Boise, ID 83702-6045 |
| Bonnie M Reed | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3090 E Gentry Way, Suite 200, Meridian, ID 83642-3550 |
| Scott J Chyna | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Sarah J Mooseau | Qualified Audiologist | St Lukes Clinic-treasure Valley LLC | 510 N 2nd St, Suite 201, Boise, ID 83702-6078 |
| Nitya Alluri | Hematology | St Lukes Clinic-treasure Valley LLC | 100 E Idaho St, Suite 302, Boise, ID 83712-6269 |
| Street Address |
3950 17TH ST |
| City | BAKER CITY |
| State | OR |
| Zip | 97814-1300 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa D Akin | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Lauren K Zink | Registered Dietitian Or Nutrition Professional | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Laura M Van Duker | Physician Assistant | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Dean N Defrees | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Marshall Hiller | Physical Therapy | Robert J Bachman Pt PC Baker Valley Physical Therapy | 3950 17th St, Suite B, Baker City, OR 97814-1300 |
| Jodi K Flanagan | Physical Therapy | Robert J Bachman Pt PC Baker Valley Physical Therapy | 3950 17th St, Suite B, Baker City, OR 97814-1300 |
| Roman J Babij | General Surgery | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Korey V Ham | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Blake Michael Marlia | Physical Therapy | Robert J Bachman Pt PC Baker Valley Physical Therapy | 3950 17th St, Suite B, Baker City, OR 97814-1300 |
| Kristina Stevens Fleming | Physical Therapy | Robert J Bachman Pt PC Baker Valley Physical Therapy | 3950 17th St, Suite B, Baker City, OR 97814-1300 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jesse D Smithson | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Neil J Carroll | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Dwaine A Tesnohlidek | General Surgery | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Monte W Anderson | Physician Assistant | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Colleen M Mcdonald | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Patrick C Denning | Physician Assistant | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Robert L Duerr | Cardiovascular Disease (cardiology) | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Jonathan D Schott | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Kerma L Cook | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Eric R Lamb | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3950 17th St, Baker City, OR 97814-1300 |
| Find all physicians in zip 97814 | |||
| City | BAKER CITY |
| Zip Code | 97814 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BAKER CITY + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Braton P Fredline.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.