Eagle Health and Wellness, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-9150 Issued in ID

Legal business name

EAGLE HEALTH AND WELLNESS, INC

Practice address

3771 N Eagle Rd
Boise, ID 83713-5005

Phone

(208) 938-4040

Fax

(208) 938-4099

NPI assigned

Mar 4, 2010

Last updated

Mar 4, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Katherine Michelle Elstun, MD

Title

President and Medical Director

Phone

(208) 938-4040

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1083937049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135005",
            "telephone_number": "208-938-4040",
            "fax_number": "208-938-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135005",
            "telephone_number": "208-938-4040",
            "fax_number": "208-938-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTH AND WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "ELSTUN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "208-938-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-2918",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1198",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-9150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S Dzieczkowski, MD
• Joanna Dziewa, APRN-CNP
• Erin M Eadington, LPC, NCC
• Matalynn Belle Eager, LPC
• Eagle Anesthesia & Oral Surgery PLLC
• Eagle Medical Supply LLC
• Eagle's View Family Medicine, PC
• Kimi Jo Eames, LCSW
• Bryan James Earl, DO
• James Benjamin Earl, MD PHD

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.