BEAR LAKE COUNTY MEMORIAL HOSPITAL (NPI# 1174741441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174741441 |
| Entity Type | Organization |
| Organization Name | BEAR LAKE COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | BEAR LAKE INTERNAL MEDICINE |
| Practice Address |
166 S 5th St Montpelier ID 83254-1557 |
| Practice Telephone | 2088471110 |
| Practice Fax Number | 2088470228 |
| Mailing Telephone | 2088471110 |
| Mailing Fax Number | 2088470228 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2012-12-17 |
| Authorized Official Name | LAURIE BINGHAM (CONTRACT MANAGEMENT) |
| Authorized Official Telephone | 2088474327 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | M7743 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806833500 | 05 |
| Other Name | Type Code |
|---|---|
| BEAR LAKE INTERNAL MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447452800 | Bear Lake County Memorial Hospital | Community/Behavioral Health | 822 Washington St, Montpelier, ID 83254-1423 | 2007-06-05 |
| 1336125533 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2005-12-20 |
| 1699057166 | Bear Lake County Memorial Hospital | Family Medicine | 465 Washington St, Montpelier, ID 83254-1544 | 2011-09-12 |
| 1376871749 | Bear Lake County Memorial Hospital | Orthopaedic Surgery | 164 S 5th St, Montpelier, ID 83254-1557 | 2009-11-24 |
| 1811138910 | Bear Lake County Memorial Hospital | Obstetrics & Gynecology | 465 Washington St, Montpelier, ID 83254-1544 | 2009-03-19 |
| 1619195989 | Bear Lake County Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-23 |
| 1699814574 | Bear Lake County Memorial Hospital | Pharmacy | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-02-06 |
| 1669521084 | Bear Lake County Memorial Hospital | Home Health | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-01-09 |
| 1740370626 | Bear Lake County Memorial Hospital | Clinic/Center | 164 S 5th St, Montpelier, ID 83254-1557 | 2006-10-13 |
| 1659461531 | Bear Lake County Memorial Hospital | Skilled Nursing Facility | 164 S 5th St, Montpelier, ID 83254-1557 | 2006-10-13 |
| Street Address |
166 S 5TH ST |
| City | MONTPELIER |
| State | ID |
| Zip Code | 83254-1557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235151077 | Vashu Deoomal Thakur | Internal Medicine | 166 S 5th St, Montpelier, ID 83254-1557 | 2006-07-24 |
| 1366677759 | Trevor Dean Jacobson | Family Medicine | 166 S 5th St, Montpelier, ID 83254-4959 | 2009-05-28 |
| 1376613851 | Joseph Edward Podany Jr. | Surgery | 166 S 5th St, Montpelier, ID 83254-1557 | 2006-11-09 |
| 1295813475 | Clay I. Campbell M.d.,p.c. | Family Medicine | 166 S 5th St, Montpelier, ID 83254-1557 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366597866 | Joseph F Decker Professional Corp | Surgery | 164 S 5th, Montpelier, ID 83254 | 2007-01-24 |
| 1447311139 | Bear Lake County | Ambulance | 385 Cemetary Road, Montpelier, ID 83254 | 2006-12-13 |
| 1073685343 | Steven D Hammond | Dentist | 455 Washington St, Montpelier, ID 83254 | 2006-11-14 |
| 1982610549 | Dorian S Grunig | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-08-01 |
| 1104840412 | Harold A Olson | Pharmacist | 765 Washington St., Montpelier, ID 83254 | 2006-07-27 |
| 1033603345 | Sydnie M Hobbs | Nurse Practitioner | 152 S 4th St, Montpelier, ID 83254 | 2018-06-20 |
| 1265505705 | Robert D Degnan | Obstetrics & Gynecology | 742 Washington St, Montpelier, ID 83254 | 2006-11-15 |
| 1952491714 | Gary Scott Griffin | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-10-13 |
| 1013027952 | Matthew Brinton Stevens | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| 1265542435 | Reset P.a. | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| Find all providers in zip 83254 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295780302 | Claudia E Lee | Internal Medicine | 55 Clarendon Ave, Montpelier, VT 05602-2119 | 2006-05-24 |
| 1487622569 | Virat V Bakhshi | Internal Medicine | 16618 Mountain Rd, Suite B, Montpelier, VA 23192-2649 | 2006-03-14 |
| 1083627426 | Carol Anne Vassar | Internal Medicine | 150 Main St, Montpelier, VT 05602-2913 | 2006-08-15 |
| 1245299957 | Mark H Dicocco | Internal Medicine | 16618 Mountain Rd, Suite B, Montpelier, VA 23192-2649 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891256004 | Ryan Thompson | Internal Medicine | 400 W Fort St # 111r, Boise, ID 83702-4531 | 2019-03-29 |
| 1306385950 | Basis Internal Medicine | Internal Medicine | 723 W Headwaters Dr, Eagle, ID 83616-5749 | 2017-02-15 |
| 1518311679 | Samantha Hersrud | Internal Medicine | 500 W Fort St 111r, Internal Medicine Residency, Boise, ID 83702 | 2016-04-14 |
| 1649634718 | Elizabeth Ann Schackmann | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2016-04-05 |
| 1003278730 | Tyler T Birch | Internal Medicine | 520 S Eagle Rd Ste 3102, Meridian, ID 83642-6352 | 2016-03-22 |
| 1134513088 | Alex Tanabe | Internal Medicine | 1000 E Park Blvd, Boise, ID 83712-7791 | 2015-03-27 |
| 1932512811 | Cory Spicer | Internal Medicine | 2265 E Sunnyside Rd, Idaho Falls, ID 83404-7598 | 2014-06-09 |
| 1598196784 | Gabriela Anghel | Internal Medicine | 500 S 11th Ave Ste 303, Pocatello, ID 83201-4879 | 2013-12-12 |
| 1871934547 | Ian Zafar Qureshi | Internal Medicine | 4400 E Flamingo Ave Ste 130, Nampa, ID 83687 | 2013-07-10 |
| 1386083764 | Avery Jeffers | Internal Medicine | 44 N. 1st E., Attn: Colleen Jensen, Preston, ID 83263-1326 | 2013-06-19 |
| Find all providers with the same taxonomy | ||||
| City | MONTPELIER |
| Zip Code | 83254 |
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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.