| Sterling Provider Group | |
|
740 S Woodruff Ave Idaho Falls ID 83401-5285 | |
| (208) 542-9111 | |
| (208) 542-9114 |
| Full Name | Sterling Provider Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 740 S Woodruff Ave, Idaho Falls, Idaho |
| Authorized Official Name and Position | Corbin Bunnage (OWNER) |
| Authorized Official Contact | 2085429111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sterling Provider Group 740 S Woodruff Ave Idaho Falls ID 83401-5285 Ph: (208) 542-9111 | Sterling Provider Group 740 S Woodruff Ave Idaho Falls ID 83401-5285 Ph: (208) 542-9111 |
| NPI Number | 1205300407 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 05/14/2020 |
| Medicare PECOS PAC ID | 2264773373 |
|---|---|
| Medicare Enrollment ID | O20190417001724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205300407 | NPI | - | NPPES |
| 13D0989496 | Other | ID | CLIA |
| Provider Name | Cynda Le Tomlinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891703070 PECOS PAC ID: 9638119969 Enrollment ID: I20080619000546 |
| Provider Name | Sheila Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538322060 PECOS PAC ID: 1052487857 Enrollment ID: I20080902000303 |
| Provider Name | Jeffrey C Haskell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073535506 PECOS PAC ID: 6709067135 Enrollment ID: I20110218000114 |
| Provider Name | Trevor D Tredennick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649264052 PECOS PAC ID: 0749232643 Enrollment ID: I20160331001356 |
| Provider Name | Jacob D Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316329220 PECOS PAC ID: 9830403013 Enrollment ID: I20160628002780 |
| Provider Name | Matthew F Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477575041 PECOS PAC ID: 1456258292 Enrollment ID: I20181116002298 |
| Provider Name | Renee Zubin Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518508506 PECOS PAC ID: 6406289289 Enrollment ID: I20191220002311 |
| Provider Name | Zachary Steven Lovell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1013557511 PECOS PAC ID: 1254767452 Enrollment ID: I20200206002644 |
| Provider Name | Ji Young An |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205435757 PECOS PAC ID: 5092121798 Enrollment ID: I20210303003226 |
| Provider Name | Kimberley Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659806941 PECOS PAC ID: 8022407030 Enrollment ID: I20211112001784 |
| Provider Name | Stephanie Ann Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285392720 PECOS PAC ID: 6002046901 Enrollment ID: I20220414002130 |
| Provider Name | Samuel Teagan Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073248787 PECOS PAC ID: 4789051244 Enrollment ID: I20221114000993 |
| Provider Name | Christopher S Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417581190 PECOS PAC ID: 0345670261 Enrollment ID: I20221118001255 |
| Provider Name | Amylia Shayne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831853100 PECOS PAC ID: 8325438427 Enrollment ID: I20230321002867 |
| Provider Name | Kathrin Bodine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124734553 PECOS PAC ID: 2860866290 Enrollment ID: I20230324002184 |
| Provider Name | Dianna Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558738666 PECOS PAC ID: 5890075717 Enrollment ID: I20230607000832 |
| Provider Name | Alicia Jorgensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770262016 PECOS PAC ID: 5890145643 Enrollment ID: I20231220002189 |
Shane G Machen, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1995 E 17th St Ste A, Idaho Falls, ID 83404 Phone: 208-522-7666 Fax: 208-524-2821 | |
Physician Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 | |
Family First Medical Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3614 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-552-7700 Fax: 208-552-1783 | |
Imed Hrs Idaho Falls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 801-507-3500 | |
Neville Spinal Balance Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2145 West Broadway Street, Idaho Falls, ID 83402 Phone: 208-522-3130 | |
R.k. Arbon, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 Channing Way, Suite 116, Idaho Falls, ID 83404 Phone: 208-529-0575 Fax: 208-528-0223 | |
Idaho Falls Family & Sports Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404 Phone: 208-524-3416 Fax: 208-524-3138 |