DIVISION OF VETERANS SERVICES (NPI# 1285624064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285624064 |
| Entity Type | Organization |
| Organization Name | DIVISION OF VETERANS SERVICES |
| Other Organization Name | IDAHO STATE VETERANS HOME - POCATELLO |
| Practice Address |
1957 Alvin Ricken Dr Pocatello ID 83201-2727 |
| Practice Telephone | 2082366340 |
| Practice Fax Number | 2082366343 |
| Mailing Telephone | 2082366340 |
| Mailing Fax Number | 2082366343 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2008-01-18 |
| Authorized Official Name | DAVID BRASUELL (ADMINISTRATOR) |
| Authorized Official Telephone | 2082366340 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 92 | ID | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | NURSING FACILITY LICENSE | 92 | 01 |
| ID | DEA | B13186271 | 01 |
| ID | NCPDP | 1307126 | 01 |
| ID | PHARMACY LICENSE | 995HP | 01 |
| Other Name | Type Code |
|---|---|
| Idaho State Veterans Home - Pocatello | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285624627 | Division of Veterans Services | Skilled Nursing Facility | 320 Collins Rd, Boise, ID 83702-4519 | 2005-10-26 |
| 1679562011 | Division of Veterans Services | Skilled Nursing Facility | 821 21st Ave, Lewiston, ID 83501-6389 | 2005-10-18 |
| Street Address |
1957 ALVIN RICKEN DR |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-2727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457964876 | Emilio Kenneth Guerrero | Physical Therapy Assistant | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2020-08-25 |
| 1811553050 | Luc Day Leech | Occupational Therapist | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2019-05-14 |
| 1851859516 | David Cox | Physical Therapist | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2019-03-12 |
| 1346704384 | Aliitasi Lynn Kelemete | Physical Therapist | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2019-01-23 |
| 1003382276 | Joel Cruz | Physical Therapy Assistant | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2018-10-16 |
| 1710460423 | Brooke Leigh Blanchard | Occupational Therapy Assistant | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2018-09-09 |
| 1629555669 | Carley Alison Warren | Speech-Language Pathologist | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2018-07-23 |
| 1003322512 | Caleb Smith | Physical Therapy Assistant | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2017-12-19 |
| 1326580663 | Leeann Kristin Shaw | Physical Therapy Assistant | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2016-11-16 |
| 1235584582 | Saunja Carlson | Speech-Language Pathologist | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2016-04-24 |
| Find all providers in the same location | ||||
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821250713 | Tanabell Health Services Inc | Skilled Nursing Facility | 1033 W Quinn Road, Pocatello, ID 83202-2425 | 2008-07-01 |
| 1407956253 | Pocatello Health Services, Inc. | Skilled Nursing Facility | 527 Memorial Drive, Pocatello, ID 83201-4063 | 2006-09-22 |
| 1346353307 | Norton & Norton LLC | Skilled Nursing Facility | 1071 Renee Ave, Pocatello, ID 83201-2508 | 2006-08-16 |
| 1407240419 | Concordia Health Care Inc | Skilled Nursing Facility | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2015-03-27 |
| 1821360868 | Valley View Health Services, Inc. | Skilled Nursing Facility | 1071 Renee Ave, Pocatello, ID 83201-2508 | 2012-02-07 |
| 1437480522 | Safe Haven Health Care LLC | Skilled Nursing Facility | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2010-01-29 |
| 1326080599 | Portneuf Medical Center | Skilled Nursing Facility | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
| 1699746198 | Beacon Health Services Inc | Skilled Nursing Facility | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1497233514 | Boise Nursing and Rehab Center LLC | Skilled Nursing Facility | 1140 N Allumbaugh St, Boise, ID 83704-8716 | 2018-07-31 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1871042663 | Ahc of Lewiston, LLC | Skilled Nursing Facility | 2852 Juniper Dr, Lewiston, ID 83501-4719 | 2016-09-22 |
| 1063966638 | Boise West of Cascadia, LLC | Skilled Nursing Facility | 8211 Ustick Road, Boise, ID 83704-5756 | 2016-08-11 |
| 1861946436 | Bellevue of Cascadia, LLC | Skilled Nursing Facility | 620 N. 6th Street, Bellevue, ID 83313 | 2016-08-11 |
| 1437603008 | Twin Falls of Cascadia, LLC | Skilled Nursing Facility | 674 Eastland Drive, Twin Falls, ID 83301-6846 | 2016-08-11 |
| 1235683806 | Payette of Cascadia, LLC | Skilled Nursing Facility | 1019 3rd Avenue South, Payette, ID 83661-2832 | 2016-08-11 |
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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.