| Emmett Family Medicine And Direct Primary Care | |
|
2001 E Quail Run Rd Emmett ID 83617-5059 | |
| (208) 365-7131 | |
| (208) 365-4464 |
| Full Name | Emmett Family Medicine And Direct Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 E Quail Run Rd, Emmett, Idaho |
| Authorized Official Name and Position | Ryan Earl White (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 2083657131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmett Family Medicine And Direct Primary Care 2001 E Quail Run Rd Emmett ID 83617-5059 Ph: (208) 365-7131 | Emmett Family Medicine And Direct Primary Care 2001 E Quail Run Rd Emmett ID 83617-5059 Ph: (208) 365-7131 |
| NPI Number | 1447629555 |
|---|---|
| Provider Enumeration Date | 09/18/2015 |
| Last Update Date | 01/12/2016 |
| Medicare PECOS PAC ID | 1355643271 |
|---|---|
| Medicare Enrollment ID | O20160111000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447629555 | NPI | - | NPPES |
| 805196400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M7802 (Idaho) | Primary |
| Provider Name | Jennifer L Petrie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891879094 PECOS PAC ID: 3072583582 Enrollment ID: I20050215000756 |
| Provider Name | Jessica Gates Seick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467049130 PECOS PAC ID: 2365832979 Enrollment ID: I20211213002658 |
Emmett Family Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2031 E Quail Run Rd, Emmett, ID 83617 Phone: 208-365-2525 Fax: 208-365-2234 | |
Valor Health Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 N Wardwell Ave, Emmett, ID 83617 Phone: 208-365-6311 Fax: 208-365-1003 | |
The Smith Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 N Wardwell Ave, Emmett, ID 83617 Phone: 208-365-6311 | |
Gem Family Practice, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 S Washington Ave, Emmett, ID 83617 Phone: 208-365-3455 Fax: 208-365-3422 | |
Valor Health Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 N Wardwell Ave, Emmett, ID 83617 Phone: 208-365-6311 | |
Idaho Behavioral Health Emmett Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 S Johns Ave, Emmett, ID 83617 Phone: 208-343-2737 Fax: 208-342-3238 |