Alliance Medical Group, LLC
Organization Active NPI Family Medicine Physician · Boise, ID
NPI 1821361387 · NPPES record last updated Feb 17, 2025
Key facts
- NPI
- 1821361387
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ALLIANCE MEDICAL GROUP, LLC
- Practice address
- 300 W Myrtle St
Boise, ID 83702-7690 - Phone
- (208) 472-9082
- Fax
- (208) 472-9083
- NPI assigned
- Feb 14, 2012
- Organization subpart
- No
Authorized official
- Name
- Linda Barnes
- Title
- Credentialing MGR
- Phone
- (208) 985-1423
Other NPIs with the same Medicare PAC ID 17
Practitioners 132
-
April Dillion, DO
-
Jedd Moore, NP
-
Joshua Allen Adams, M.D.
-
Ginger A. Allen, MD
-
Daryn J. Barnes, PA-C
-
Sam G Battaglia, MD
-
Brianna Battles, NP
-
Ryan Anthony Baugher, D.O.
-
Karen Ann Bean, NP
-
Nickolas R Becar, PA-C
-
Joanna Beck, PA-C
-
Matthew M Bender, MD
-
Chloe J Berger, PA
-
Sydney Brown, DNP-APRN
-
Crystalyn Lou Bryan, NP-C
-
Joel J Burch, PA
-
Ryan Burke, PA
-
Krista Marie Bush, FNP-C
-
Christopher Alexander Cahan, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2043748 | Primary Health Medical Group - Downtown | Provider-performed microscopy | Jul 9, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121210000408 | ID | DME Supplier - Physician - General Practice | 3971544685 | Practice locations: Boise, ID |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
300 W Myrtle St
Boise, ID 83702-7690
Mailing address
PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500
Other names
- Primary Health Medical Group
Other providers in Boise, ID
- Alliance Medical Group, LLC
- Alliance Medical Group, LLC
- Alliance Medical Group, LLC
- Alliance Medical Group, LLC
- Alliance Medical Group, LLC
- Alliance Medical Group, LLC
- Alliance Physical Medicine
- Alliance Soft Tissue Center
- Allied Care Givers
- Allied Orthopaedics LLC
All providers in Boise, ID · Family Medicine 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 17, 2025. 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.