Charles E Eiriksson Jr., MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

M4580 Issued in ID

Practice address

300 E Jeffreson
Ste 101
Boise, ID 83712

Phone

(208) 336-4141

Fax

(208) 336-4035

NPI assigned

May 20, 2006

Last updated

Mar 28, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Gooding County Hospital District

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1295769537
  NPD (past)
• Ica Cath Lab LLC

  • Internal Medicine Physician
  • Boise, ID
  • NPI 1205881851
  NPD (past)
• Idaho Cardiology Associates PA

  • Interventional Cardiology Physician
  • Boise, ID
  • NPI 1346295623
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1932153137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E JEFFRESON",
            "address_2": "STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-336-4141",
            "fax_number": "208-336-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIRIKSSON",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ID",
            "license": "M4580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Eicher Jr., RN
• Jeffery J Eidson, MD
• Amaya Aurora Eiguren, M.A., L.P.C.
• Linda Sue Eiler
• April Eilers-Isla, CNP
• Erika Leigh Eisele, PSY.D.
• Kelly Eisenbarger, MSW
• Michael John Eisenbeiss Sr., PSYCHOLOGIST COUNSEL
• Amanda P Eisenberg, LPC, LAMFT
• Mary-Katherine Ekins, MS, LPC

• Interventional Cardiology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Interventional Cardiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.