IDAHO DEPT OF HEALTH & WELFARE REG II CMH MOSCOW (NPI# 1720116551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720116551 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE REG II CMH MOSCOW |
| Practice Address |
1350 Troy Hwy Moscow ID 83543-3995 |
| Practice Telephone | 2088820562 |
| Practice Fax Number | 2088828575 |
| Mailing Telephone | 2088820562 |
| Mailing Fax Number | 2088828575 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | VICKI R. MALONE (PROGRAM MANAGER) |
| Authorized Official Telephone | 2087994440 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD | 000010018450 | 01 | |
| ID | 8073500 | 05 | |
| BLUE CROSS OF IDAHO | HW140 | 01 |
| Street Address |
1350 TROY HWY |
| City | MOSCOW |
| State | ID |
| Zip Code | 83543-3995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326176132 | Idaho Dept of Health & Welfare Reg II Amh Moscow | Clinic/Center | 1350 Troy Hwy, Moscow, ID 83843-3995 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063451722 | Ambulance Service Inc | Ambulance | 510 Oak St, Nez Perce, ID 83543 | 2006-06-06 |
| 1366480394 | St. Mary's Hospital | Nurse Practitioner | 501 Oak, Nezperce, ID 83543 | 2006-06-03 |
| 1982746939 | Nezperce Joint School District #302 | Local Education Agency (LEA) | 615 2nd Avenue, Nezperce, ID 83543-0297 | 2007-02-13 |
| 1417286451 | C Robert Pratt | Legal Medicine | 510 Oak St, Room 5, Nezperce, ID 83543-5064 | 2009-12-22 |
| 1053640094 | Rodney D Piller | Legal Medicine | 510 Oak St, Room 5, Nezperce, ID 83543-5064 | 2009-12-22 |
| 1467780429 | Lewis County Idaho Coroner | Legal Medicine | 510 Oak St, Room 5, Nezperce, ID 83543-5064 | 2009-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171649 | Andrea Beth Corbin | Registered Nurse | 202 Eagle Point Dr, Moscow, OH 45153-9665 | 2020-10-13 |
| 1750998126 | Story Family Medicine | Family Medicine | 1150 Alturas Dr Ste 101, Moscow, ID 83843-3263 | 2020-09-29 |
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1063030237 | Brandon Garfield | Specialist/Technologist | 3287 W Twin Rd, Moscow, ID 83843-8130 | 2020-07-14 |
| 1003434283 | Luisa Broden | Student in an Organized Health Care Education/Training Program | 902 N Almon St Apt 3, Moscow, ID 83843-8544 | 2020-07-14 |
| 1811515067 | Lexis Fouts | Specialist/Technologist | 617 W Taylor Ave # A, Moscow, ID 83843-2411 | 2020-07-13 |
| 1063039204 | Jadelyn Taylor Eisele | Specialist/Technologist | 707 Railroad St Apt 4, Moscow, ID 83843-2381 | 2020-07-04 |
| 1366069593 | Tyler Hempfling Volkmann | Specialist/Technologist | 924 Indian Hills Dr, Moscow, ID 83843-5096 | 2020-07-03 |
| 1013531680 | Dalton Tanner Pitts | Specialist/Technologist | 1433 W A St, Moscow, ID 83843-3274 | 2020-05-29 |
| Find all providers in MOSCOW | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043657828 | Bodybalance Pt Twin Falls LLC | Clinic/Center | 657 Blue Lakes Blvd N, Twin Falls, ID 83301-4036 | 2013-06-03 |
| 1669503066 | Idaho Dept of Health & Welfare R5 Cmh Psr Jer | Clinic/Center | 126 N Adams St, Jerome, ID 83338-2331 | 2007-03-08 |
| 1396876850 | Idaho Dept. of Health & Welfare | Clinic/Center | 803 Harrison St., Twin Falls, ID 83301-3925 | 2007-03-08 |
| 1164550455 | Idaho Dept of Health & Welfare Reg 1 Cmh Psr Cda | Clinic/Center | 1250 Ironwood Dr Ste 100, Coeur D Alene, ID 83814-2628 | 2007-03-01 |
| 1023487105 | Journey Pediatric Therapy | Clinic/Center | 506 Alder St Fl 2, Sandpoint, ID 83864-1567 | 2015-09-18 |
| 1851787980 | Fit Technologies Pllc | Clinic/Center | 3544 E 17th St, Suite 201, Ammon, ID 83406-6911 | 2015-04-15 |
| 1053729434 | Celebration Speech Inc | Clinic/Center | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 | 2014-07-29 |
| 1689082182 | Generations Occupational Therapy | Clinic/Center | 3715 Woodking Dr, Idaho Falls, ID 83404-4720 | 2014-07-28 |
| 1942616073 | St Luke's Elks Childrens Rehabilitation | Clinic/Center | 3525 E Louise Dr, Suite 255, Meridian, ID 83642-6302 | 2014-07-09 |
| 1750620159 | Saint Alphonsus Regional Medical Center Inc | Clinic/Center | 4400 E Flamingo Ave, Nampa, ID 83687 | 2013-02-05 |
| 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.