PORTNEUF REHAB CENTER (NPI# 1144262114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144262114 |
| Entity Type | Organization |
| Organization Name | PORTNEUF REHAB CENTER |
| Other Organization Name | PORTNEUF REHABILITATION CENTER |
| Practice Address |
777 Hospital Way Pocatello ID 83201-5175 |
| Practice Telephone | 2082391000 |
| Practice Fax Number | 2082391934 |
| Mailing Telephone | 2082391000 |
| Mailing Fax Number | 2082391934 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-11-15 |
| Authorized Official Name | MR. JOHN ABREU (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2082391020 |
| Is Organization Subpart | Y |
| Parent Organization Name | PORTNEUF MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | H12 | ID | Hospital Units |
| Other Name | Type Code |
|---|---|
| Portneuf Rehabilitation Center | Doing Business As Name - Organization |
| Street Address |
777 HOSPITAL WAY |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825892 | Gregory S Harrison | Neurological Surgery | 777 Hospital Way, Suite 115, Pocatello, ID 83201-5175 | 2005-07-15 |
| 1801401344 | Sunny Blue Alene Nelson | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-09-11 |
| 1316570757 | Mark Alan Pendleton | Nurse Anesthetist, Certified Registered | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-02-13 |
| 1508413220 | Hilary Worthen | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-08-19 |
| 1437612447 | Walter S Medlin Md PC | Surgery | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-04-08 |
| 1396203428 | Amber Frost | Family Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-03-07 |
| 1649756404 | Kamilla Gundersen | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83207 | 2018-07-16 |
| 1043716285 | Brice Anderson | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-04-05 |
| 1851808133 | Rocky Mountain Physician Group LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-08 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
| 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 | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285833343 | St Lukes Magic Valley Regional Medical Center Ltd | Rehabilitation Unit | 775 Pole Line Road West, Suite 307, Twin Falls, ID 83301 | 2007-07-17 |
| 1730505199 | St Lukes Regional Medical Center | Rehabilitation Unit | 600 N Robbins Rd, Boise, ID 83702-4565 | 2014-03-10 |
| 1265870216 | St. Luke's Elks Rehab | Rehabilitation Unit | 405 W Myrtle St, Boise, ID 83702-7658 | 2013-06-12 |
| 1669819496 | Elks Rehab | Rehabilitation Unit | 405 W Myrtle St, Boise, ID 83702-7658 | 2013-06-03 |
| 1659476455 | Kootenai Health | Rehabilitation Unit | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2006-09-14 |
| 1316960354 | Saint Alphonsus Regional Medical Center Inc | Rehabilitation Unit | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2006-07-25 |
| 1952355935 | Eastern Idaho Health Services, Inc. | Rehabilitation Unit | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2006-05-22 |
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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.