Individual provider Active NPI

Devin Douglas Dredge, D.O.

  • Emergency Medicine Physician
  • Caldwell, ID
National Provider Identifier
1720468101
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
O-1169 Issued in ID
Practice address
1717 Arlington Ave Dept of
Caldwell, ID 83605
Phone
(208) 459-4641
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O-1169 ID Primary
Emergency Medicine Physician 207P00000X R-10301 IA

Addresses

Primary practice location

1717 Arlington Ave Dept of
Caldwell, ID 83605

Mailing address

1717 Arlington Ave Dept of
Caldwell, ID 83605-4802

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180718000710 ID Practitioner - Emergency Medicine 4587976691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carepoint Health Emergency Medicine Idaho PLLCGroup PAC ID 6406283860, 14 clinicians

Practice addresses (Care Compare)

1717 Arlington Ave
Caldwell, ID 83605-4802
Phone (208) 459-4641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Carepoint Health Emergency Medicine Idaho, PLLC Emergency Medicine CurrentSince Feb 1, 2020 Accepting new patients

Locations

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1720468101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 ARLINGTON AVE DEPT OF",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 ARLINGTON AVE DEPT OF",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-459-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREDGE",
        "first_name": "DEVIN",
        "middle_name": "DOUGLAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1169",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "R-10301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.