GREENWALD NEUROSURGICAL (NPI# 1124198403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124198403 |
| Entity Type | Organization |
| Organization Name | GREENWALD NEUROSURGICAL |
| Practice Address |
3155 Channing Way Suite B Idaho Falls ID 83404-7546 |
| Practice Telephone | 2085354800 |
| Practice Fax Number | 2085354807 |
| Mailing Telephone | 2085354800 |
| Mailing Fax Number | 2085354807 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2009-07-13 |
| Authorized Official Name | MS. JANEENE A DITMORE (OFFICE MANAGER) |
| Authorized Official Telephone | 2085354800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | M-6947 | ID | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS | 76836 | 01 |
| ID | BLUE CROSS PRACTICE | 8M987 | 01 |
| ID | BLUE SHIELD | 000010001551 | 01 |
| Street Address |
3155 CHANNING WAY SUITE B |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134155666 | Brent H. Greenwald | Neurological Surgery | 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7546 | 2006-06-25 |
| 1740693050 | Mark Thompson | Physical Therapist | 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 | 2014-06-04 |
| 1417383654 | Jed G Loertscher | Physical Therapist | 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 | 2013-09-19 |
| 1700174489 | Christopher A Rigby | Physical Therapist | 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 | 2011-07-15 |
| 1215220587 | Greg J Bailey | Physical Therapist | 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 | 2011-05-19 |
| 1760621080 | Kari Anne Lasco-sanders | Physical Therapist | 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 | 2009-02-10 |
| 1215089768 | Shannon Kay West | Specialist/Technologist, Other | 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7561 | 2007-01-17 |
| 1528127057 | Greenwald Neurosurgical PC | Surgery | 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7561 | 2006-12-08 |
| 1871687970 | Nathan Allen Hunsaker | Specialist | 3155 Channing Way, Suite D, Idaho Falls, ID 83404-7534 | 2006-10-03 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932429545 | Sherri Stacey | Specialist | 2862 Bungalow Dr, Idaho Falls, ID 83401-6011 | 2010-06-04 |
| 1366767790 | Eliseo Guerra | Specialist | 457 I St, Idaho Falls, ID 83402-2842 | 2010-03-29 |
| 1609106079 | Danielle Joy Adams | Specialist | 777 Hoopes Ave, Apt I-103, Idaho Falls, ID 83401-4972 | 2010-01-07 |
| 1306075098 | Nevada Lee Walker | Specialist | 316 N Bellin Rd, Idaho Falls, ID 83402-2357 | 2009-07-02 |
| 1770729279 | Charles Todd Storms | Specialist | 720 S Woodruff Ave, Idaho Falls, ID 83401-5285 | 2009-01-05 |
| 1205030368 | Idaho Falls Hand Surgery | Specialist | 933 S Utah, Idaho Falls, ID 83404 | 2007-06-13 |
| 1093860710 | Brenda M Fritz | Specialist | 2570 Channing Way, Idaho Falls, ID 83404-7515 | 2007-01-24 |
| 1821106089 | Daniel K Hinckley | Specialist | 2065 E 17th St, Suite A, Idaho Falls, ID 83404-8042 | 2006-08-28 |
| 1063527158 | Pro Heal Hyperbarics & Wound Care | Specialist | 2325 Coronaod, Idaho Falls, ID 83404 | 2006-08-20 |
| 1275552291 | Mark Edward Freeman | Specialist | 1855 Madison Avenue, Idaho Falls, ID 83404 | 2006-07-19 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on GREENWALD NEUROSURGICAL.
| 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.