Idaho Allergy L.L.C.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

M103 Issued in ID

Legal business name

IDAHO ALLERGY L.L.C.

Practice address

379 E Shore Dr
Suite 100
Eagle, ID 83616-5410

Phone

(208) 938-3443

Fax

(208) 938-3553

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Stephen B Fritz, M.D.

Title

President

Phone

(208) 938-3443

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1477866606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 E SHORE DR",
            "address_2": "SUITE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165410",
            "telephone_number": "208-938-3443",
            "fax_number": "208-938-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 E SHORE DR",
            "address_2": "SUITE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165410",
            "telephone_number": "208-938-3443",
            "fax_number": "208-938-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO ALLERGY L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "FRITZ",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-938-3443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "ID",
            "license": "M103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David R. Hulbert, M.D.
• Carl Scott Humphrey, MD
• Carrie Ann Humphrey, MD
• James J Hunt, PHARMD
• Mary Ann Z. Huntington, MD
• Idaho Center for Regenerative Medicine
• Idaho Innovative Dentistry, PLLC (Premier Dentistry of Eagle)
• Idaho Massage LLC
• Idaho Massage LLC
• Idaho Nutrition Associates, LLC

• Allergy Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Allergy Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.