| Key Stone Health Care | |
|
21 N Fisher Park Way Eagle ID 83616-4796 | |
| (208) 514-0670 | |
| (208) 549-7880 |
| Full Name | Key Stone Health Care |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 21 N Fisher Park Way, Eagle, Idaho |
| Authorized Official Name and Position | Leonard R Jensen (PRESIDENT) |
| Authorized Official Contact | 5035236404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Key Stone Health Care 21 N Fisher Park Way Eagle ID 83616-4796 Ph: (208) 514-0670 | Key Stone Health Care 21 N Fisher Park Way Eagle ID 83616-4796 Ph: (208) 514-0670 |
| NPI Number | 1932520640 |
|---|---|
| Provider Enumeration Date | 12/23/2013 |
| Last Update Date | 12/11/2020 |
| Medicare PECOS PAC ID | 0648402784 |
|---|---|
| Medicare Enrollment ID | O20140403002234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932520640 | NPI | - | NPPES |
| Provider Name | Matthew L Walker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003831249 PECOS PAC ID: 2668452624 Enrollment ID: I20040727001233 |
| Provider Name | Corey E Dupont |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639334279 PECOS PAC ID: 3577639392 Enrollment ID: I20080902000441 |
| Provider Name | Jamia E Byrns |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881676070 PECOS PAC ID: 8123178225 Enrollment ID: I20090611000305 |
| Provider Name | Khristopher E Korell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336433184 PECOS PAC ID: 0244408706 Enrollment ID: I20110727000770 |
| Provider Name | Leonard R Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851604904 PECOS PAC ID: 0042223687 Enrollment ID: I20120820000613 |
| Provider Name | Carla D Dirmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851624282 PECOS PAC ID: 2961549456 Enrollment ID: I20141203002169 |
| Provider Name | Vanessa Mae Klaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912300807 PECOS PAC ID: 5092936641 Enrollment ID: I20150320001106 |
| Provider Name | Christine A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891176798 PECOS PAC ID: 1850606369 Enrollment ID: I20150812009000 |
| Provider Name | Amy M Dancer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407214497 PECOS PAC ID: 3971800947 Enrollment ID: I20160318001626 |
| Provider Name | Kara M Kuntz |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1891057246 PECOS PAC ID: 0345470282 Enrollment ID: I20160809002853 |
| Provider Name | Kami C Bellomy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952852642 PECOS PAC ID: 9739468471 Enrollment ID: I20161121000109 |
| Provider Name | Matthew T Genther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548784606 PECOS PAC ID: 1153695119 Enrollment ID: I20170914003608 |
| Provider Name | Mason D Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376188698 PECOS PAC ID: 0941638746 Enrollment ID: I20200310000119 |
| Provider Name | Tyler S Burton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669003695 PECOS PAC ID: 6002243607 Enrollment ID: I20200317001446 |
| Provider Name | Caitlin E Mohr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346535952 PECOS PAC ID: 0143440255 Enrollment ID: I20200506003396 |
| Provider Name | Megan A Dunay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801107974 PECOS PAC ID: 3678710415 Enrollment ID: I20200605000519 |
| Provider Name | James Donald Mcgregor |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1093165912 PECOS PAC ID: 7719270479 Enrollment ID: I20200817003439 |
| Provider Name | Kathryn L Stednitz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033373071 PECOS PAC ID: 9234205212 Enrollment ID: I20210423000317 |
| Provider Name | Cody J Bonine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528730165 PECOS PAC ID: 5193119238 Enrollment ID: I20220307000254 |
| Provider Name | Jessica L Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114613593 PECOS PAC ID: 3779945548 Enrollment ID: I20230810000859 |
| Provider Name | Nicholas M Brandi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225858475 PECOS PAC ID: 0749716686 Enrollment ID: I20241216001038 |
Brook Medical Pllc 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 | |
Alliance Medical Group, Llc 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 | |
Saint Alphonsus Physician Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 323 East Riverside Drive, Suite 224, Eagle, ID 83616 Phone: 208-367-5750 Fax: 208-367-5765 |