| Caring Edge Op LLC | |
|
77 N Fisher Park Way Eagle ID 83616 | |
| (208) 473-2717 | |
| (877) 890-5617 |
| Full Name | Caring Edge Op LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 77 N Fisher Park Way, Eagle, Idaho |
| Authorized Official Name and Position | Christopher Lougheed (PROVIDER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2088669001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caring Edge Op LLC 2965 E Tarpon Dr Ste 150 Meridian ID 83642-9007 Ph: (208) 287-9420 | Caring Edge Op LLC 77 N Fisher Park Way Eagle ID 83616 Ph: (208) 473-2717 |
| NPI Number | 1700399359 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 09/05/2018 |
| Medicare PECOS PAC ID | 6406114131 |
|---|---|
| Medicare Enrollment ID | O20180423002099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700399359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Amy B Cermak |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598866212 PECOS PAC ID: 8022198902 Enrollment ID: I20080104000228 |
| Provider Name | Laura Beth Marquardt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629557624 PECOS PAC ID: 3870845878 Enrollment ID: I20181002002064 |
| Provider Name | Amber Wahl |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215333984 PECOS PAC ID: 3476806779 Enrollment ID: I20181105000358 |
| Provider Name | Marcus Sickler |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588146674 PECOS PAC ID: 5597000703 Enrollment ID: I20181217001610 |
| Provider Name | Katie Jo Hagen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699171074 PECOS PAC ID: 2769720747 Enrollment ID: I20190218001038 |
| Provider Name | Shaunna a Messmer-lavalley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952946444 PECOS PAC ID: 9830529320 Enrollment ID: I20200424000179 |
| Provider Name | Kristin Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427413269 PECOS PAC ID: 2365872637 Enrollment ID: I20200429000921 |
| Provider Name | Laura Melin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225506413 PECOS PAC ID: 5092059352 Enrollment ID: I20200715002916 |
| Provider Name | Jennifer Ingold |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649678251 PECOS PAC ID: 5799170056 Enrollment ID: I20220323001511 |
| Provider Name | Alex Fontaine |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437867413 PECOS PAC ID: 8325416019 Enrollment ID: I20221130003110 |
| Provider Name | Haley Robin Baldock |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447106729 PECOS PAC ID: 2264916576 Enrollment ID: I20260324002938 |
| Provider Name | Sarah M Jacobs |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1659556512 PECOS PAC ID: 9931675873 Enrollment ID: I20260417000827 |
| Provider Name | Adria Lamb |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871336495 PECOS PAC ID: 7517430424 Enrollment ID: I20260623001471 |
Eagle Creek Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1281 E. Iron Eagle Dr, Eagle, ID 83616 Phone: 208-939-5535 Fax: 208-939-5536 |
Primary Health Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1895 Mcgrath Rd, Eagle, ID 83616 Phone: 208-939-8200 Fax: 208-939-8222 |
Enhanced Aesthetics and Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 367 S Academy Ln, Eagle, ID 83616 Phone: 985-778-7582 |
Family & Functional Medicine of Idaho PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 W State St, Suite 250, Eagle, ID 83616 Phone: 208-947-0925 Fax: 208-947-0926 |
Linda D Burke MD PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 445 S. Fitness Place, Eagle, ID 83616 Phone: 208-939-2332 Fax: 208-939-7676 |
Summit Medical Providers LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2205 E Riverside Dr, Eagle, ID 83616 Phone: 801-867-9760 Fax: 801-880-4400 |