TETON CARDIOVASCULAR AND PULMONARY LAB,LLC (NPI# 1699784413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699784413 |
| Entity Type | Organization |
| Organization Name | TETON CARDIOVASCULAR AND PULMONARY LAB,LLC |
| Other Organization Name | SNAKE RIVER CARDIOVASCULAR & PULMONARY LABORATORY |
| Practice Address |
2001 S Woodruff Ave Suite 12 B Idaho Falls ID 83404-6374 |
| Practice Telephone | 2085292498 |
| Practice Fax Number | 2085287971 |
| Mailing Telephone | 2085292498 |
| Mailing Fax Number | 2085287971 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK L MILLER (PRESIDENT) |
| Authorized Official Telephone | 2085292498 |
| Authorized Official Credential | R.C.S., R.V.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD OF IDAHO | 000010153937 | 01 |
| ID | 807391800 | 05 | |
| ID | BLUE CROSS OF IDAHO | 8M795 | 01 |
| Other Name | Type Code |
|---|---|
| Snake River Cardiovascular & Pulmonary Laboratory | Doing Business As Name - Organization |
| Street Address |
2001 S WOODRUFF AVE SUITE 12 B |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-6374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902809221 | James L. Richards | Surgery | 2001 S Woodruff Ave, Ste 3, Idaho Falls, ID 83404-6371 | 2005-05-31 |
| 1568912962 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2001 S Woodruff Ave, Suite 7, Idaho Falls, ID 83404-6374 | 2016-10-10 |
| 1780043042 | Teton Obstetrics and Gynecology Pa | Obstetrics & Gynecology | 2001 S Woodruff Ave, Suite 10, Idaho Falls, ID 83404-6374 | 2016-02-15 |
| 1730563909 | Radial First Cardiovascular Associates, LLC | Internal Medicine | 2001 S Woodruff Ave, Suite 3, Idaho Falls, ID 83404-6371 | 2015-07-16 |
| 1609263482 | Chad Steven Dahle | Spec/Tech, Cardiovascular | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2015-04-20 |
| 1225314677 | Janae Lynn Dye | Respiratory Therapist, Certified | 2001 S Woodruff Ave, Idaho Falls, ID 83404-6374 | 2011-10-31 |
| 1366747594 | Will G Stewart | Respiratory Therapist, Registered | 2001 S Woodruff Ave, Suite 12b, Idaho Falls, ID 83404-6374 | 2011-01-19 |
| 1043546260 | Ihc Health Services Inc | Internal Medicine | 2001 S Woodruff Ave, #12, Idaho Falls, ID 83404-6374 | 2009-10-22 |
| 1609008614 | Blake A. Stragier | Technician, Cardiology | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2009-08-10 |
| 1770712762 | Brandy Skaar | Respiratory Therapist, Registered | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2009-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063807626 | Clearview Ultrasound Inc. | Physiological Laboratory | 16670 Ustick Rd, Caldwell, ID 83607-9611 | 2015-03-31 |
| 1730316613 | Pulmonary Testing Center LLC | Physiological Laboratory | 122 N State St Ste B, Preston, ID 83263-1143 | 2009-06-17 |
| 1881649234 | Mri Mobile Holdings Limited Partnership | Physiological Laboratory | 1512 12th Avenue Road, Nampa, ID 83686-6008 | 2006-05-24 |
| 1679958896 | Schryver Medical Sales and Marketing, LLC | Physiological Laboratory | 2399 S Orchard St, Suite 105, Boise, ID 83705-3793 | 2015-07-29 |
| 1265489785 | Diagnostic Health Corporation | Physiological Laboratory | 8800 W Emerald St, Boise, ID 83704-8205 | 2006-05-29 |
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on TETON CARDIOVASCULAR AND PULMONARY LAB,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.