Organization Active NPI

John M McNulty MD PC

  • Orthopaedic Surgery Physician
  • Kellogg, ID
National Provider Identifier
1194996470
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M7646 Issued in ID
Legal business name
JOHN M MCNULTY MD PC
Practice address
740 McKinley Ave
Kellogg, ID 83837-2693
Phone
(208) 783-1267
NPI assigned
Mar 14, 2008
Last updated
Mar 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Dr. John M McNulty, MD
Title
Self
Phone
(208) 784-7017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X M7646 ID Primary

Addresses

Primary practice location

740 McKinley Ave
Kellogg, ID 83837-2693

Mailing address

862 Cherry Creek Rd
St Maries, ID 83861-9329
Phone (208) 245-9233

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1194996470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 CHERRY CREEK RD",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838619329",
            "telephone_number": "208-245-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MCKINLEY AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372693",
            "telephone_number": "208-783-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M MCNULTY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SELF",
        "authorized_official_telephone_number": "208-784-7017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M7646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kellogg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.