TETON OPEN MRI OF POCATELLO, LLC (NPI# 1194798397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194798397 |
| Entity Type | Organization |
| Organization Name | TETON OPEN MRI OF POCATELLO, LLC |
| Practice Address |
246 N 18th Ave Pocatello ID 83201-3356 |
| Practice Telephone | 2085520828 |
| Practice Fax Number | 2085520829 |
| Mailing Telephone | 2085520828 |
| Mailing Fax Number | 2085520829 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. BONNIE C GRAY (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 2085520828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Street Address |
246 N 18TH AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-3356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598750838 | John M Fornarotto | Ophthalmology | 246 N 18th Ave, Pocatello, ID 83201-3356 | 2005-09-13 |
| 1790838662 | John Fornarotto Pllc | Ophthalmology | 246 N 18th Ave, Pocatello, ID 83201-3356 | 2007-01-22 |
| 1184653404 | Ryan Scott Johnson | Optometrist | 246 N 18th Ave, Pocatello, ID 83201-3356 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699175158 | Allied Imaging Inc | Clinic/Center | 2043 E Center St Ste 115, Pocatello, ID 83201-3300 | 2014-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982042693 | Alliance Healthcare Services Inc | Clinic/Center | 3581 E Overland Rd, Meridian, ID 83642-6757 | 2013-06-05 |
| 1316003726 | Advanced Open Imaging Boise LLC | Clinic/Center | 3581 East Overland Rd, Meridian, ID 83642 | 2006-12-29 |
| 1437178399 | Idaho Facial Imaging LLC | Clinic/Center | 8119 Ustick Rd, Suite 101, Boise, ID 83704-5754 | 2006-07-19 |
| 1053305144 | Teton Mri of Idaho Falls | Clinic/Center | 2060 S Woodruff Ave, Idaho Falls, ID 83404-6396 | 2005-09-06 |
| 1982037107 | Sjrmc Interventional Radiology Services LLC | Clinic/Center | 415 6th St, Lewiston, ID 83501-2431 | 2013-08-12 |
| 1659528511 | Imaging Center of Idaho, LLC | Clinic/Center | 4519 Enterprise Way, Caldwell, ID 83605-8086 | 2008-08-22 |
| 1326230590 | Cassia Physicians Billing | Clinic/Center | 1501 Hiland Ave, Burley, ID 83318-2682 | 2007-08-13 |
| 1508991373 | Not-tsoo Gah-nee Indiane Health Services | Clinic/Center | Mission Road, Fort Hall, ID 83203 | 2007-02-22 |
| 1669483509 | Twin Falls Imaging and Diagnostic Center | Clinic/Center | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-08-09 |
| 1629031760 | Swient, LLC | Clinic/Center | 900 N Liberty St, Suite 305, Boise, ID 83704-8704 | 2006-04-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.