Surgical Group, P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SURGICAL GROUP, P.A.

Practice address

404 E Elm St
Caldwell, ID 83605-4846

Phone

(208) 459-0028

Fax

(208) 459-0380

NPI assigned

Apr 11, 2006

Last updated

Apr 13, 2010By 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

Jon Agee, M.D.NPI 1710941026

Title

President

Phone

(208) 459-0028

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jon Moore Agee, M.D.

  • Surgery Physician
  • Caldwell, ID
  • NPI 1710941026
  Authorized official Same address or phone

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1609839398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E ELM ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054846",
            "telephone_number": "208-459-0028",
            "fax_number": "208-459-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E ELM ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054846",
            "telephone_number": "208-459-0028",
            "fax_number": "208-459-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "AGEE",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-459-0028",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002483000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "87460",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Cherie Stuck, LCPC
• Kaysea Lee Studioso-Hatch, DO
• Deborah Lee Sullivan, ARNP
• Samuel M Summers, MD
• Jacob Sup, DO
• Brendon James Swenson, D.D.S., M.S.
• Holly Taft, LCSW
• John Christopher Taggart Jr., LPC
• Gloria Tague, LSW
• Sherri Lynn Talford

• Surgery Physician in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.