PHS MD #1, LLC (NPI# 1124355813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124355813 |
| Entity Type | Organization |
| Organization Name | PHS MD #1, LLC |
| Other Organization Name | PORTNEUF MEDICAL PRACTICES |
| Practice Address |
651 Memorial Dr Pocatello ID 83201-4071 |
| Mailing Address |
Po Box 4168 Pocatello ID 83205-4168 |
| Practice Telephone | 2082392110 |
| Practice Fax Number | 2082392145 |
| Mailing Telephone | 2082392110 |
| Mailing Fax Number | 2082392145 |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2010-03-02 |
| Authorized Official Name | JOHN ABREU (CFO) |
| Authorized Official Telephone | 2082392110 |
| Is Organization Subpart | Y |
| Parent Organization Name | POCATELLO HEALTH SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PORTNEUF MEDICAL PRACTICES | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992032098 | Phs Md #1, LLC | Clinic/Center | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2009-11-10 |
| Street Address |
651 MEMORIAL DR |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871558239 | Michael L Francisco | Internal Medicine | 651 Memorial Dr, Portneuf Cancer Center, Pocatello, ID 83201 | 2006-04-19 |
| 1497051544 | Pocatello Health Services, LLC | Psychologist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2011-02-08 |
| 1760719454 | Phs Md #2, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
| 1689802852 | Pocatello Health Services, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-06-26 |
| 1760610935 | Pocatello Hospital, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-06-26 |
| 1295974368 | William E Hogan | Family Medicine | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-02-13 |
| 1083852727 | Pocatello Health Services, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-02-03 |
| 1932369568 | Ana Joy Weinhold | Family Medicine | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-17 |
| 1528228806 | Steven D Proctor | Social Worker | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-11 |
| 1871753061 | Elisabeth Gayle Kinghorn | Clinical Nurse Specialist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-11 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1760739973 | Pocatello Family Medicine | Clinic/Center | 465 Memorial Drive, Pocatello, ID 83201-4008 | 2012-08-07 |
| 1508875881 | Primary Care Specialists, Pa | Clinic/Center | 110 Vista Drive, Pocatello, ID 83201 | 2006-08-05 |
| 1003231911 | Need-a-nurse Medical Staffing, LLC | Clinic/Center | 476 E Chubbuck Rd, Pocatello, ID 83202-1816 | 2014-02-28 |
| 1275894065 | Alice D. Bollinger | Clinic/Center | 444 Hospital Way, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1700147543 | Becky Lee Morrison | Clinic/Center | 444 Hospital Way, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1245591080 | Colleen E. Hallinan | Clinic/Center | 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1548521396 | Nanette Marie Phinney | Clinic/Center | 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1285936781 | Bmh Inc. | Clinic/Center | 2302 E Terry St, Pocatello, ID 83201-2733 | 2010-12-03 |
| 1992032098 | Phs Md #1, LLC | Clinic/Center | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2009-11-10 |
| Find all providers in POCATELLO | ||||
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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.