| Meza Post Acute And Long Term Care, Pllc | |
|
3400 E Fernan Hill Rd Coeur D Alene ID 83814-7588 | |
| (208) 819-2183 | |
| Not Available |
| Full Name | Meza Post Acute And Long Term Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3400 E Fernan Hill Rd, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Michael Meza (OWNER) |
| Authorized Official Contact | 2088192183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meza Post Acute And Long Term Care, Pllc Po Box 3687 Coeur D Alene ID 83816-2529 Ph: (208) 819-2183 | Meza Post Acute And Long Term Care, Pllc 3400 E Fernan Hill Rd Coeur D Alene ID 83814-7588 Ph: (208) 819-2183 |
| NPI Number | 1932725215 |
|---|---|
| Provider Enumeration Date | 06/22/2020 |
| Last Update Date | 12/08/2020 |
| Medicare PECOS PAC ID | 4981028503 |
|---|---|
| Medicare Enrollment ID | O20200715002977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932725215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Barbara A Kammer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306957048 PECOS PAC ID: 9436053980 Enrollment ID: I20031125000725 |
| Provider Name | Michael G Meza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134124506 PECOS PAC ID: 6901940048 Enrollment ID: I20100212000562 |
| Provider Name | William Scott Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255351458 PECOS PAC ID: 7719966811 Enrollment ID: I20120612000136 |
| Provider Name | Robert Jordan Lakko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174756340 PECOS PAC ID: 2062648132 Enrollment ID: I20151007000620 |
| Provider Name | Jason R Schwintek |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992864342 PECOS PAC ID: 7810968799 Enrollment ID: I20151022001060 |
| Provider Name | John Bradley Rudolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548503022 PECOS PAC ID: 1759604309 Enrollment ID: I20170116000186 |
| Provider Name | Rachael Ferraro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902090350 PECOS PAC ID: 5597816199 Enrollment ID: I20190717001446 |
| Provider Name | Alexandra Bellem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639533847 PECOS PAC ID: 3870822828 Enrollment ID: I20190917001511 |
| Provider Name | Brandon L Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124353719 PECOS PAC ID: 9436572740 Enrollment ID: I20201124003092 |
| Provider Name | Lisa Kailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316559073 PECOS PAC ID: 2264847193 Enrollment ID: I20210702000538 |
| Provider Name | Connie Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881228781 PECOS PAC ID: 8123430709 Enrollment ID: I20220531001490 |
| Provider Name | Laure M Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154086429 PECOS PAC ID: 9739574260 Enrollment ID: I20220827000639 |
| Provider Name | Megan J Beaudin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992492805 PECOS PAC ID: 9830557974 Enrollment ID: I20230621002213 |
| Provider Name | Whitney A Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669178356 PECOS PAC ID: 9335507375 Enrollment ID: I20230622002647 |
| Provider Name | Ryan Joseph Daly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356124432 PECOS PAC ID: 0749635985 Enrollment ID: I20231009001925 |
| Provider Name | Mario Seyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942251293 PECOS PAC ID: 0749248623 Enrollment ID: I20240101000269 |
| Provider Name | Shayleigh Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285466797 PECOS PAC ID: 8921548611 Enrollment ID: I20240909002918 |
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