Organization Active NPI

Saint Alphonsus Physician Services Inc

Doing business as Saint Alphonsus Medical Group Meridian Health Plaza

  • Family Medicine Physician
  • Meridian, ID
National Provider Identifier
1114977824
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT ALPHONSUS PHYSICIAN SERVICES INC
Doing business as
Saint Alphonsus Medical Group Meridian Health Plaza
Practice address
3025 W Cherry LN
Suite B
Meridian, ID 83642-8531
Phone
(208) 367-8550
Fax
(208) 367-8555
NPI assigned
May 11, 2006
Last updated
Dec 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Ms. Janelle G. Reilly
Title
President
Phone
(208) 367-6490

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Advanced Practice Midwife 367A00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

3025 W Cherry LN
Suite B
Meridian, ID 83642-8531

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170

Other names 1

  • Saint Alphonsus Medical Group Meridian Health Plaza Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1114977824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 W CHERRY LN",
            "address_2": "SUITE B",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428531",
            "telephone_number": "208-367-8550",
            "fax_number": "208-367-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ALPHONSUS PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-367-6490",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Alphonsus Medical Group Meridian Health Plaza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.