NPIMap

Organization Active NPI

Premier Emergency Physicians of Idaho Medical Group

  • Emergency Medicine Physician
  • Kellogg, ID
National Provider Identifier
1336223379
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PREMIER EMERGENCY PHYSICIANS OF IDAHO MEDICAL GROUP
Practice address
3 Jacobs Gulch Rd
Kellogg, ID 83837-2023
Phone
(208) 784-1221
NPI assigned
Oct 25, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Dr. Joseph H. Gatewood, MD
Title
President Premier Emerency Physicia
Phone
(800) 444-7009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

3 Jacobs Gulch Rd
Kellogg, ID 83837-2023

Mailing address

PO Box 8120
Philadelphia, PA 19101-8120
Phone (800) 444-7009

National Provider Directory

National Provider Directory
Tax ID family
Premier Emergency Physicians of Idaho Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1336223379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8120",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191018120",
            "telephone_number": "800-444-7009",
            "fax_number": "800-305-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 JACOBS GULCH RD",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372023",
            "telephone_number": "208-784-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EMERGENCY PHYSICIANS OF IDAHO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "GATEWOOD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT PREMIER EMERENCY PHYSICIA",
        "authorized_official_telephone_number": "800-444-7009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "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 24, 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.