| Roberta J Carr, PA-C | |
|
111 Bever Grade, Lapwai, ID 83540-0367 | |
| (208) 843-2271 | |
| (208) 843-2658 |
| Full Name | Roberta J Carr |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 111 Bever Grade, Lapwai, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306856547 | NPI | - | NPPES |
| 805010100 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA287 (Idaho) | Primary |
| Entity Name | Gritman Medical Center Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1619988144 PECOS PAC ID: 8729070164 Enrollment ID: O20040908001492 |
| Entity Name | Gritman Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538634522 PECOS PAC ID: 0941545784 Enrollment ID: O20181221002296 |
| Entity Name | Hospitalist Medicine Physicians of Idaho- Nampa PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558995316 PECOS PAC ID: 2365871688 Enrollment ID: O20200407001850 |
| Mailing Address | Practice Location Address |
|---|---|
| Roberta J Carr, PA-C Po Box 367, Lapwai, ID 83540-0367 Ph: (208) 843-2271 | Roberta J Carr, PA-C 111 Bever Grade, Lapwai, ID 83540-0367 Ph: (208) 843-2271 |
Peter James Cunningham, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 111 Beaver Grade Rd, Lapwai, ID 83540 Phone: 208-843-2271 |