Treasure Valley Cardiology PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

M5449 Issued in ID

Legal business name

TREASURE VALLEY CARDIOLOGY PC

Practice address

900 N Liberty St
Suite 302
Boise, ID 83704-8704

Phone

(208) 322-1686

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Graham Wetherley, M.D.

Title

President

Phone

(208) 322-1686

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1184657389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9589",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837074589",
            "telephone_number": "208-472-8117",
            "fax_number": "208-472-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST",
            "address_2": "SUITE 302",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048704",
            "telephone_number": "208-322-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY CARDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "WETHERLEY",
        "authorized_official_first_name": "GRAHAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-322-1686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M5449",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP642A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002180300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807805900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Boise, ID
• Providers in Boise, ID by specialty
• Cardiovascular Disease Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.