Idaho Urology Clinic, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

M2768 Issued in ID

Legal business name

IDAHO UROLOGY CLINIC, P.A.

Practice address

1613 12TH Ave Rd Ste B
Nampa, ID 83686-6183

Phone

(208) 466-2461

Fax

(208) 466-2488

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Wilfred E Watkins, M.D.NPI 1710981162

Title

Owner

Phone

(208) 466-2461

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Wilfred E Watkins, M.D., F.A.C.S.

  • Specialist
  • Nampa, ID
  • NPI 1710981162
  NPD Authorized official
• Eric W Klein, M.D.,MPH, TM

  • Specialist
  • Meridian, ID
  • NPI 1023013109
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1598811945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 12TH AVE RD STE B",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866183",
            "telephone_number": "208-466-2461",
            "fax_number": "208-466-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 12TH AVE RD STE B",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866183",
            "telephone_number": "208-466-2461",
            "fax_number": "208-466-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO UROLOGY CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "WILFRED",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-466-2461",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "M2768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002409100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP NPI",
            "identifier": "1598811945",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Physicians Eyecare Group, P.C.
• Idaho Sleep Services, LLC (Idaho Sleep Health)
• Idaho Sleep Solutions, LLC
• Idaho Surgical, LLC
• Idaho Therapy Source
• Idaho Vascular Institute PLLC
• Idahodhwbh3 Nampa CMH PSR
• Ian Clint Idayan, PT
• Ideal Mental Health, LLC
• Jacalyn R Iliff, PHARMD

• Specialist in Nampa, ID
• Providers in Nampa, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.