Frontier Pediatric Partners PLLC
Organization Active NPI Pediatrics Physician · Twin Falls, ID
NPI 1780146316 · NPPES record last updated Feb 10, 2023
Key facts
- NPI
- 1780146316
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- FRONTIER PEDIATRIC PARTNERS PLLC
- Practice address
- 1502 Locust Street N #700
Twin Falls, ID 83301 - Phone
- (208) 595-5095
- Fax
- (208) 595-5258
- NPI assigned
- Apr 2, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher Adam Eyre, MD
- Title
- Member
- Phone
- (208) 595-5095
Practitioners 10
-
Samantha Ruth Chartier, PA-C
-
Corinne Bartschi, FNP
-
Kasey Scott Cook, DO
-
Jared L Hansen, M.D.
-
Nancy Mann, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2171440 | Frontier Pediatric Partners PLLC | Provider-performed microscopy | Aug 29, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210113002964 | ID | Part B Supplier - Mass Immunization (Roster Biller Only) | 2062825920 |
Receives reassigned benefits from 1 practitioner Practice locations: Twin Falls, ID |
National Provider Directory
Locations
1502 Locust St N
Ste 700
Twin Falls, ID 83301
Phone (208) 595-5095
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
1502 Locust Street N #700
Twin Falls, ID 83301
Mailing address
1502 Locust Street North
Ste 700
Twin Falls, ID 83301-4164
Phone (208) 595-5095
Other providers in Twin Falls, ID
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- Sarah Friend
- Christopher Allen Frix
- From the Heart, Inc.
- Sonia Fry
- Barbara Jane Fuchs
- Daniel Scott Fuchs
- Edward L Fuchs
- Brooke Marie-Osgood Fukuoka
All providers in Twin Falls, ID · Pediatrics Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.