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ELMER G DODGE FNP NPI 1508918236


NPI Information

NPI: 1508918236
Provider Name: ELMER G DODGE, FNP
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
9858 W STATE ST
STAR, ID
ZIP 83669
Phone: (208) 286-0666
Get Directions

Elmer G Dodge, FNP is a nurse practitioner in Star, ID. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Elmer G Dodge, FNP NPI is 1508918236. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9858 W STATE ST
STAR, ID
ZIP 83669-210
Phone: (208) 286-0666
Fax: (208) 286-0565

The NPI 1508918236 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 9/1/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WG0000XRegistered NurseGeneral PracticeNP534AIDAHONo
2363L00000XNurse PractitionerNP-534AIDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1806045400MEDICAIDIDAHO
2NPQP7OTHERIDAHOBLUE CROSS OF IDAHO
3000010150031OTHERIDAHOREGENCE BLUE SHIELD OF ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.