IDAHO INDEPENDENT MRI LLC (NPI# 1255345765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255345765 |
| Entity Type | Organization |
| Organization Name | IDAHO INDEPENDENT MRI LLC |
| Practice Address |
562 Shoup Ave W Twin Falls ID 83301-5029 |
| Practice Telephone | 2087321205 |
| Mailing Telephone | 2087321205 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | FREDERICK L SURBAUGH (OWNER) |
| Authorized Official Telephone | 2087321205 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| Street Address |
562 SHOUP AVE W |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-5029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659316875 | Twin Falls Orthopedics, Pllc | Specialist | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-06-19 |
| 1972741882 | Stephanie A Latimer | Registered Nurse | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2009-01-30 |
| 1053589432 | Twin Falls Orthopedics LLC | Nurse Practitioner | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2008-02-19 |
| 1336346469 | Twin Falls Orthopedics Pllc | Nurse Practitioner | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2007-07-02 |
| 1275685356 | Charlene Surbaugh | Registered Nurse | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2007-01-17 |
| 1124185053 | Twin Falls Imaging & Diagnostic Center LLC | Clinic/Center | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2007-01-02 |
| 1922168723 | Patricia Lincoln | Specialist | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-12-11 |
| 1225139298 | Pro Active Advantage, LLC | Counselor | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-09-25 |
| 1669483509 | Twin Falls Imaging and Diagnostic Center | Clinic/Center | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104225531 | Allied Portable X-ray Inc | Clinic/Center | 1255 Filer Ave E Ste C, Twin Falls, ID 83301-4118 | 2014-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548879943 | Heritage Imaging, Inc. | Clinic/Center | 12554 W. Bridger St. Suite 118, Boise, ID 83713-1582 | 2020-07-31 |
| 1730445214 | Onsite Diagnostic Solutions | Clinic/Center | 9133 N Orange Blossom Ct, Hayden, ID 83835-8748 | 2012-04-09 |
| 1730408170 | Alliance Healthcare Services Inc | Clinic/Center | 1702 16th St, Lewiston, ID 83501-3911 | 2010-05-25 |
| 1023028529 | Alliance Healthcare Services Inc | Clinic/Center | 1300 E Mullan Ave # 700, Post Falls, ID 83854-6052 | 2006-08-08 |
| 1588634356 | Portable Xray of Idaho LLC | Clinic/Center | 2399 S Orchard St, Boise, ID 83705-3793 | 2006-01-25 |
| 1508875360 | Diagnostic Imaging Service of Idaho | Clinic/Center | 1951 Bench Rd, Suite F, Pocatello, ID 83201-2073 | 2006-08-07 |
| City | TWIN FALLS |
| Zip Code | 83301 |
Please comment or provide details below to improve the information on IDAHO INDEPENDENT MRI LLC.
| 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.