Indian Creek Family Medicine,LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INDIAN CREEK FAMILY MEDICINE,LLC

Practice address

708 E Wythe Creek CT
Ste. 103
Kuna, ID 83634-2473

Phone

(208) 922-5338

Fax

(208) 922-5340

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael D Holden, MDNPI 1558366088

Title

Owner

Phone

(208) 922-5338

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael D Holden, MD

  • Family Medicine Physician
  • Quincy, IL
  • NPI 1558366088
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487743845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 E WYTHE CREEK CT",
            "address_2": "STE. 103",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342473",
            "telephone_number": "208-922-5338",
            "fax_number": "208-922-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 E WYTHE CREEK CT",
            "address_2": "STE. 103",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342473",
            "telephone_number": "208-922-5338",
            "fax_number": "208-922-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN CREEK FAMILY MEDICINE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-922-5338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Kenneth Hornbeck
• Jace Thomas Hudon, LMSW
• Noel Hudon, LCSW
• Id Specialty Dental Services, PLLC
• Idaho Dental Professionals, P.C.
• Integrate Family Occupational Therapy
• Darrell Jackson
• Michael Jangula
• Andrea Jensen
• Sharina E Jensen, CD(DONA), CLC

• Family Medicine Physician in Kuna, ID
• Providers in Kuna, ID by specialty
• Family Medicine Physician 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.