Idaho Emergency Medical Group PC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

IDAHO EMERGENCY MEDICAL GROUP PC

Practice address

1717 Arlington Ave
Caldwell, ID 83605-4802

Phone

(208) 459-4641

Fax

(208) 455-3717

NPI assigned

Jan 20, 2016

Last updated

Mar 4, 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

Sharon Hardy

Title

Pe Director

Phone

(925) 251-6901

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1417314543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HOPYARD RD",
            "address_2": "SUITE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883348",
            "telephone_number": "925-924-1600",
            "fax_number": "925-924-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 ARLINGTON AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054802",
            "telephone_number": "208-459-4641",
            "fax_number": "208-455-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO EMERGENCY MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PE DIRECTOR",
        "authorized_official_telephone_number": "925-251-6901"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Idaho Diagnostic Sleep Lab, Inc. (Western Sleep Disorders Center)
• Idaho Sleep and Neurology PLLC
• Idaho Sleep and Neurology, PLLC
• Idaho Surgery Center, LLC
• Idahodhwbh3 Cald Amh PSR
• Idahodhwbh3 Caldwell CMH PSR

• Emergency Medicine Physician in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Emergency Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.