Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
ID license #M-14615CA license #A100346taxonomy 207Q00000X
Identifiers
Type
Value
Notes
05 (CA)
A00100346
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Medicare directory context
Attributes below come from the CMS Doctors & Clinicians dataset used by Medicare Care Compare,
retrieved 2026-10-12. They apply only to this clinician's public Medicare listing.
Medicare specialties
Family Practice
Medical school
Ohio State University College Of Medicine
Graduation year 2005
Largest Medicare group
1155 members
Largest listed enrollment group
Facility affiliations reported by CMS
Ancora Hospice And Palliative Services Llc
Saint Alphonsus Regional Medical Center Inc
St Lukes Clinic-Treasure Valley Llc
Medicare listing data does not guarantee that a clinician is accepting new patients or that a service is covered.
View the CMS dataset →
Practice context
Part of a multi-provider practice. 388 other active providers share this practice address in NPPES.
Recently enumerated nearby: 10 new family medicine providers have been added in Boise in the last 180 days.
See all →
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