TETON RADIOLOGY DIAGNOSTIC, LLC (NPI# 1194969725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194969725 |
| Entity Type | Organization |
| Organization Name | TETON RADIOLOGY DIAGNOSTIC, LLC |
| Practice Address |
2001 S Woodruff Ave Ste 17 Idaho Falls ID 83404-6372 |
| Mailing Address |
Po Box 2147 Idaho Falls ID 83403-2147 |
| Practice Telephone | 2085247237 |
| Mailing Telephone | 2085528769 |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |
| Authorized Official Name | MR. MICHAEL P HODEL (GENERAL MANAGER) |
| Authorized Official Telephone | 2085425000 |
| Is Organization Subpart | Y |
| Parent Organization Name | TETON RADIOLOGY DIAGNOSITC, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| Street Address |
2001 S WOODRUFF AVE STE 17 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-6372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013085604 | Teton Radiology Diagnostic LLC | Radiology | 2001 S Woodruff Ave Ste 17, Idaho Falls, ID 83404-6372 | 2006-12-01 |
| 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 | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467709352 | A Window Within Imaging Center | Radiology | 723 Pine St, Sandpoint, ID 83864-1486 | 2012-08-09 |
| 1407081060 | Teton Radiology Madison LLC | Radiology | 425 E 4th N, Rexburg, ID 83440-5390 | 2009-05-26 |
| 1841291861 | Charles W Maile | Radiology | 520 North Third, Sandpoint, ID 83864-1507 | 2005-08-02 |
| 1023246741 | Chad Eric Sarver | Radiology | 500 W Fort St, Boise, ID 83702-4501 | 2009-07-01 |
| 1679710123 | Russell W Wright | Radiology | 190 E Bannock St, C/o Boise Radiology Group, Boise, ID 83712-6241 | 2009-01-20 |
| 1447402425 | Christopher James Malcom | Radiology | 4519 Enterprise Way, Caldwell, ID 83605-8055 | 2008-10-21 |
| 1326257064 | Mark Ryan Papenfuss | Radiology | 1055 N Curtis Road, Boise, ID 83706-1309 | 2007-05-21 |
| 1841392982 | Jeffrey Carl Bickel | Radiology | 415 6th St, Lewiston, ID 83501-2431 | 2006-09-01 |
| 1609829613 | Frederick B Fitts Jr. | Radiology | 1501 Hiland Ave, Burley, ID 83318-2682 | 2006-05-19 |
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on TETON RADIOLOGY DIAGNOSTIC, LLC.
| 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.