Individual provider Active NPI

Joel Thomas Webb, PA-C

  • Physician Assistant
  • Preston, ID
National Provider Identifier
1184872632
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-766 Issued in ID
Practice address
47 N 1St E
Preston, ID 83263
Phone
(208) 852-2900
Fax
(208) 852-3511
NPI assigned
Sep 8, 2008
Last updated
Jul 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-766 ID Primary

Addresses

Primary practice location

47 N 1St E
Preston, ID 83263

Mailing address

44 N 1St E
Preston, ID 83263-1326
Phone (208) 852-3662

Other identifiers 2

IdentifierTypeStateIssuer
PA-766OtherIDPHYSICIAN ASSISTANT LICENSE
1184872632MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090428000547 ID Practitioner - Physician Assistant 3577611730 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franklin County Medical CenterGroup PAC ID 8820909104, 25 clinicians

Practice addresses (Care Compare)

44 N 1St
Preston, ID 83263-1326
Phone (208) 852-0137

64 N 1St
Suite 200
Preston, ID 83263-1326
Phone (208) 852-3662

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin County Medical Center CurrentSince Jun 1, 2016 Accepting new patients
Idaho Em I Medical Services PC Physician Assistant Past Accepting new patients
Franklin County Medical Center Past Accepting new patients
Pebble Creek Emergency Physicians PLLC Past Accepting new patients

Locations

44 N 1st E
Preston, ID 83263
Phone (208) 852-0137

47 N 1st E
Preston, ID 83263
Phone (208) 852-2900

64 N 1st E
Ste 100
Preston, ID 83263
Phone (208) 852-0137

Interoperability endpoints

  • Direct secure messaging: joel.webb.1@17373.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1184872632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631326",
            "telephone_number": "208-852-3662",
            "fax_number": "208-852-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "83263",
            "telephone_number": "208-852-2900",
            "fax_number": "208-852-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "JOEL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA-766",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184872632",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Preston, ID

Sources for this page

Verify at the official NPI Registry.