Ann C Agnew, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M9138 Issued in ID

Practice address

3080 E Gentry Way Ste 210
Meridian, ID 83642-3013

Phone

(208) 947-5390

Fax

(208) 947-3465

NPI assigned

Jun 12, 2006

Last updated

Jul 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Copper Falls Hospice LLC

  • Community Based Hospice Care Agency
  • Meridian, ID
  • NPI 1881468189

  Contracted Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rocky Mountain Care - Palliative Care LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Woods Cross, UT
  • NPI 1386224814

  ID

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298

  Internal Medicine

  NPD (past)
• Apogee Medical Group Idaho PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1518086651
  NPD (past)
• Inpatient Consultants of Missouri Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1194779579
  NPD (past)
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1497797302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 E OPUS ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837165274",
            "telephone_number": "208-344-4824",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY STE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423013",
            "telephone_number": "208-947-5390",
            "fax_number": "208-947-3465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-367-7350",
            "fax_number": "208-367-3951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-367-7350",
            "fax_number": "208-367-3951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "ANN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "M9138",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M9138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melissa M. M. Agoudemos, M.D.
• Phillip C Agrusa, MD
• Ahc Home Health of Boise LLC (Aspen Home Care and Hospice)
• Ahc Medical Supply, LLC (AHC Medical Supply)
• Ahc of Boise LLC (Aspen Transitional Rehab)

• Internal Medicine Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.