Forrest R Fredline (NPI# 1245493840, PAC ID# 5092955054) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1245493840 |
| PAC ID by PECOS | 5092955054 |
| Professional Enrollment ID | I20130716000203 |
| Full Name | Forrest R Fredline |
| Organization Legal Name | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC |
| Address |
4400 E Flamingo Ave Suite 302 Nampa ID 83687-9203 |
| Phone Number | 2083022200 |
| Gender | M |
| Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 3476462359 |
| Number of Group Practice Members | 468 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130013 | SAINT ALPHONSUS MEDICAL CENTER - NAMPA |
| 130007 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1055 N Curtis Rd, Boise, ID 83706-1309 | 2083672145 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC |
| 4400 E Flamingo Ave, Suite 302, Nampa, ID 83687-9203 | 2083022200 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC |
| Organization Legal Name | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC |
| Physicians | 481 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Micah Tobin | Physician Assistant | Saint Alphonsus Regional Medical Center Inc | 315 E Elm St, Suite 100, Caldwell, ID 83605-4858 |
| Jayne A Derr | Clinical Social Worker | Saint Alphonsus Regional Medical Center Inc | 131 N Allumbaugh St, Boise, ID 83704-9204 |
| Michael R Partin | Physician Assistant | Saint Alphonsus Regional Medical Center Inc | 3123 Medical Dr, Caldwell, ID 83605-6972 |
| Ondrej Choutka | Neurosurgery | Saint Alphonsus Regional Medical Center Inc | 1072 N Liberty St, Boise, ID 83704-8708 |
| Mitchell A Mendenhall | Family Medicine | Saint Alphonsus Regional Medical Center Inc | 11035 Karcher Rd, Nampa, ID 83651-8200 |
| Erika V Aragona | Osteopathic Manipulative Medicine | Saint Alphonsus Regional Medical Center Inc | 3217 W Bavaria St, Eagle, ID 83616-5171 |
| Todd R Woodward | Physician Assistant | Saint Alphonsus Regional Medical Center Inc | 6051 W Emerald St, Boise, ID 83704-8969 |
| Alanna E Lilly | Physician Assistant | Saint Alphonsus Regional Medical Center Inc | 757 E Wythe Creek Ct, Suite 100, Kuna, ID 83634-5006 |
| Katy F Connley | Nurse Practitioner | Saint Alphonsus Regional Medical Center Inc | 3250 W Cherry Ln, Meridian, ID 83642-1120 |
| Jennifer S Anderson | Cardiovascular Disease (cardiology) | Saint Alphonsus Regional Medical Center Inc | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Street Address |
4400 E FLAMINGO AVE SUITE 302 |
| City | NAMPA |
| State | ID |
| Zip | 83687-9203 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leo S Harf | Ophthalmology | Intermountain Eye and Laser Centers Pllc | 4400 E Flamingo Ave, Suite 300, Nampa, ID 83687-9203 |
| Bobby Chawla | Hematology/oncology | Saint Alphonsus Regional Medical Center Inc | 4400 E Flamingo Ave, Suite 302, Nampa, ID 83687-9203 |
| Tejesh Srinivasa Reddy | Hospitalist | Sound Physicians of Idaho | 4400 E Flamingo Ave, Nampa, ID 83687-9203 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jocelyn A Benton | Physician Assistant | Lifestages Ob-gyn Pllc | 3908 E Flamingo Ave, Nampa, ID 83687-3102 |
| Jeffrey Ryan Moreno | Clinical Social Worker | Stellar Mental Health and Mediation, LLC | 3904 E Flamingo Ave, Nampa, ID 83687-3102 |
| Allyson A Bates | Nurse Practitioner | Lifestages Ob-gyn Pllc | 3908 E Flamingo Ave, Nampa, ID 83687-3102 |
| Juliette E Hughes | Obstetrics/gynecology | Lifestages Ob-gyn Pllc | 3908 E Flamingo Ave, Nampa, ID 83687-3102 |
| Jynnah Leigh Snow | Nurse Practitioner | Stellar Mental Health and Mediation, LLC | 3904 E Flamingo Ave, Nampa, ID 83687-3102 |
| Janine M Franco | Physician Assistant | Lifestages Ob-gyn Pllc | 3908 E Flamingo Ave, Nampa, ID 83687-3102 |
| Michelle Chin | Nurse Practitioner | Stellar Mental Health and Mediation, LLC | 3904 E Flamingo Ave, Nampa, ID 83687-3102 |
| Dustan T Hughes | Obstetrics/gynecology | Lifestages Ob-gyn Pllc | 3908 E Flamingo Ave, Nampa, ID 83687-3102 |
| Rick A Heikkila | Clinical Social Worker | Stellar Mental Health and Mediation, LLC | 3904 E Flamingo Ave, Nampa, ID 83687-3102 |
| Christoffer A Spoja | Internal Medicine | Sound Physicians of Idaho | 4300 E Flamingo Ave, Nampa, ID 83687-3138 |
| Find all physicians in zip 83687 | |||
| City | NAMPA |
| Zip Code | 83687 |
| Specialty | GENERAL SURGERY |
| City + Specialty | NAMPA + GENERAL SURGERY |
Please comment or provide details below to improve the information on Forrest R 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.