Medical Surgical Group Inc

Primary specialty

Mammography Clinic/CenterTaxonomy code 261QR0206X

License

164590 Issued in ID

Legal business name

MEDICAL SURGICAL GROUP INC

Practice address

307 Saint Johns Way
Suite 6
Lewiston, ID 83501-2435

Phone

(208) 743-0962

NPI assigned

Nov 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael John Hoffman

Title

Business Manager

Phone

(208) 743-0962

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306917000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 SAINT JOHNS WAY",
            "address_2": "SUITE 6",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012435",
            "telephone_number": "208-743-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 SAINT JOHNS WAY",
            "address_2": "SUITE 6",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012435",
            "telephone_number": "208-743-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SURGICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "208-743-0962"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "ID",
            "license": "164590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "000010005483",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7025844",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8987-0",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary McPherson
• Karen Meadows, MED
• Madison Meadows
• Christopher Adam Mecklenburg, PHARMD
• Seker Medavarapu, PT
• Delia Medlin, PH.D.
• Penny Angela Melder, PHARMD
• Leslie Meredith, LMP
• Jenna Andreas Rashell Messick, MS., CCC-SLP
• Judy A Metelko, CNS,ARNP

• Mammography Clinic/Center in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Mammography Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.