| C-who | |
|
824 S Diamond St Nampa ID 83686-5960 | |
| (208) 606-0396 | |
| Not Available |
| Full Name | C-who |
|---|---|
| Speciality | Clinic/Center |
| Location | 824 S Diamond St, Nampa, Idaho |
| Authorized Official Name and Position | Jennifer Yturriondobeitia (CEO) |
| Authorized Official Contact | 2088999012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C-who 11485 Payette Heights Rd Payette ID 83661-5012 Ph: (208) 899-9012 | C-who 824 S Diamond St Nampa ID 83686-5960 Ph: (208) 606-0396 |
| NPI Number | 1164153508 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 03/13/2023 |
| Certification Date | 03/13/2023 |
| Medicare PECOS PAC ID | 9830564665 |
|---|---|
| Medicare Enrollment ID | O20230410002158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164153508 | NPI | - | NPPES |
| 020256 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Roger S Malm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730190935 PECOS PAC ID: 2961468939 Enrollment ID: I20041202000217 |
| Provider Name | Alanna E Lilly |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093182479 PECOS PAC ID: 0547570434 Enrollment ID: I20151104002843 |
| Provider Name | Melissa Catherine Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750512521 PECOS PAC ID: 4587894373 Enrollment ID: I20220323000946 |
| Provider Name | Kaitlin Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457828451 PECOS PAC ID: 0143617373 Enrollment ID: I20220418002254 |
| Provider Name | Leo Alfred Carney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811972706 PECOS PAC ID: 4183628597 Enrollment ID: I20230707000638 |
| Provider Name | Sara Barrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760948897 PECOS PAC ID: 2567795024 Enrollment ID: I20260311001236 |
First Care Medical of Idaho, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 232 2nd St S, Nampa, ID 83651 Phone: 208-461-6523 |
Rocky Mountain Health Partners, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1018 W Sanetta St Ste 108, Nampa, ID 83651 Phone: 208-800-0404 Fax: 208-615-4090 |
Mercy Physician Group Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1512 12th Ave Rd, Nampa, ID 83686 Phone: 208-463-5000 Fax: 208-463-5578 |
Greene Mountain Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3719 Wheeler Cir, Nampa, ID 83686 Phone: 208-695-0388 Fax: 208-606-3682 |
Terry Reilly Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 207 1st St S, Nampa, ID 83651 Phone: 208-466-7869 Fax: 208-466-5359 |
Northwest Nazarene University Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 S University Blvd, Nampa, ID 83686 Phone: 208-467-8643 |