NPI age
18 years
Enumerated 2007-10-18
● Active Type 2 · Organization
Meadow Lake Surgery Center Inc
Meadow Lake Surgery Center Inc is 1 of 99 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wigod
M.D.
Last NPPES update
2013-09-16
Source: monthly bulk 2026-05
How this organization compares
Across 99 active clinic/center providers in Idaho.
NPI age
18 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-10Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
3630 E Louise Dr, Suite 200
Meridian, ID 836427975
Mailing address
3630 E Louise Dr, Suite 200
Meridian, ID 836427975
Authorized official
Mark D Wigod, M.D.
M.D.
📞 2083779515
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Chamagne Eaton, CST Specialist/Technologist, Other NPI 1508197666
- Jacqueline King Clinic/Center NPI 1871749408
- Rebecca Shaw, CFA Surgery NPI 1275772667
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.