IDAHO FALLS CLINIC, P.A. (NPI# 1811932411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811932411 |
| Entity Type | Organization |
| Organization Name | IDAHO FALLS CLINIC, P.A. |
| Practice Address |
2001 S Woodruff Ave Suite #15 Idaho Falls ID 83404-6374 |
| Practice Telephone | 2085227310 |
| Practice Fax Number | 2085240559 |
| Mailing Telephone | 2085227310 |
| Mailing Fax Number | 2085240559 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. CHRISTINE C. CLARK (ADMINISTRATOR) |
| Authorized Official Telephone | 2085227310 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | RR MEDICARE | P9154 | 01 |
| ID | TRICARE | I843154 | 01 |
| ID | BLUE CROSS | 88468 | 01 |
| Street Address |
2001 S WOODRUFF AVE SUITE #15 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
| 1104065093 | Neville Spinal Balance Pllc | Clinic/Center | 2145 West Broadway Street, Idaho Falls, ID 83402-2904 | 2009-02-17 |
| 1396361358 | Eyedaho Optometric LLC | Clinic/Center | 500 S Utah Ave, Idaho Falls, ID 83402-3305 | 2020-06-24 |
| 1457698565 | Badger Inc. | Clinic/Center | 1970 E 17th St, Suite 202, Idaho Falls, ID 83404-8014 | 2013-01-09 |
| 1841564333 | Community Care Channing Way LLC | Clinic/Center | 2725 Channing Way, Idaho Falls, ID 83404-7510 | 2012-02-29 |
| 1811273501 | Advanced Chiropractic Neurology and Internal Medicine | Clinic/Center | 1542 Elk Creek Dr, Idaho Falls, ID 83404-8322 | 2011-10-26 |
| 1295825115 | Associated Counseling | Clinic/Center | 2539 Channing Way, Suite #240, Idaho Falls, ID 83404-7544 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992323216 | Wolf Pack LLC | Clinic/Center | 939 S 25th E Ste 115, Ammon, ID 83406-5736 | 2020-07-13 |
| 1164072187 | Peter John Leichtnam | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-12 |
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| 1104316785 | Pend Oreille Vision Care | Clinic/Center | 6132 Highway 2, Priest River, ID 83856 | 2018-05-18 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.