Table Rock Mobile Medicine PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1252A Issued in ID

Legal business name

TABLE ROCK MOBILE MEDICINE PLLC

Practice address

3090 E Gentry Way Ste 210
Meridian, ID 83642-3550

Phone

(986) 224-8420

Fax

(844) 268-7286

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Bradley Bigford, MSN, NP-CNPI 1588007843

Title

Sole Member

Phone

(986) 224-8420

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Alexander Bigford, NP-C

  • Family Nurse Practitioner
  • Meridian, ID
  • NPI 1588007843
  NPD Authorized official
• Jessica L Ahlers, CFNP

  • Nurse Practitioner
  • Meridian, ID
  • NPI 1528661154
  NPD
• Kayla Denise Salcido, FNP-C

  • Family Nurse Practitioner
  • Meridian, ID
  • NPI 1518443266

  Single Specialty

  NPD
• Jayson Paul Smith, N.P.

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1982202743
  NPD (past)

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715385600000",
    "number": "1194186437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44953",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837110953",
            "telephone_number": "986-224-8424",
            "fax_number": "208-504-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 E GENTRY WAY STE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423550",
            "telephone_number": "986-224-8420",
            "fax_number": "844-268-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABLE ROCK MOBILE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A",
        "authorized_official_last_name": "BIGFORD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "986-224-8420",
        "authorized_official_credential": "MSN, NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1252A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori L Sylves-Muench, RN, MSN, FNP, APN-BC
• Synergy 208 LLC
• Daniel Szarvas, DDS
• Cole Daniel Szymkiewicz, AGANCP-BC
• T-Medica Mobil Anesthesia Inc.
• Tadje Orthopaedics, LLC
• Jared P Tadje, MD
• Elizabeth L Talboy, HOLISTIC HEALTH PRAC
• Tale Prime Care
• Chad Dennis Talford, PA-C

• Family Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; 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.