PORTNEUF MEDICAL CENTER (NPI# 1326080599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326080599 |
Entity Type | Organization |
Organization Name | PORTNEUF MEDICAL CENTER |
Other Organization Name | PORTNEUF CARE CENTER |
Practice Address |
651 Memorial Dr Pocatello ID 83201-4071 |
Practice Telephone | 2082391000 |
Practice Fax Number | 2082392112 |
Mailing Telephone | 2082391000 |
Mailing Fax Number | 2082392112 |
Enumeration Date | 2006-06-12 |
Last Update Date | 2020-08-22 |
Authorized Official Name | JOHNATHAN WILKER (VP FINANCE & CFO) |
Authorized Official Telephone | 2082391020 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | H12 | ID | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Portneuf Care Center | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417210568 | Portneuf Medical Center | General Acute Care Hospital | 777 Hospital Way, Pocatello, ID 83201-5175 | 2012-06-22 |
1205005832 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-02-28 |
1679742209 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-02-28 |
1538351796 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2007-08-13 |
1750323515 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
1578505335 | Portneuf Medical Center | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
1437191418 | Portneuf Medical Center | Pharmacist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
1053353227 | Portneuf Medical Center | Home Health | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
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 |
1124355813 | Phs Md #1, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
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 |
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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 | 314000000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Skilled Nursing Facility |
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821250713 | Tanabell Health Services Inc | Skilled Nursing Facility | 1033 W Quinn Road, Pocatello, ID 83202-2425 | 2008-07-01 |
1407956253 | Pocatello Health Services, Inc. | Skilled Nursing Facility | 527 Memorial Drive, Pocatello, ID 83201-4063 | 2006-09-22 |
1346353307 | Norton & Norton LLC | Skilled Nursing Facility | 1071 Renee Ave, Pocatello, ID 83201-2508 | 2006-08-16 |
1285624064 | Division of Veterans Services | Skilled Nursing Facility | 1957 Alvin Ricken Dr, Pocatello, ID 83201-2727 | 2005-10-24 |
1407240419 | Concordia Health Care Inc | Skilled Nursing Facility | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2015-03-27 |
1821360868 | Valley View Health Services, Inc. | Skilled Nursing Facility | 1071 Renee Ave, Pocatello, ID 83201-2508 | 2012-02-07 |
1437480522 | Safe Haven Health Care LLC | Skilled Nursing Facility | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2010-01-29 |
1699746198 | Beacon Health Services Inc | Skilled Nursing Facility | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2006-02-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
1497233514 | Boise Nursing and Rehab Center LLC | Skilled Nursing Facility | 1140 N Allumbaugh St, Boise, ID 83704-8716 | 2018-07-31 |
1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
1871042663 | Ahc of Lewiston, LLC | Skilled Nursing Facility | 2852 Juniper Dr, Lewiston, ID 83501-4719 | 2016-09-22 |
1063966638 | Boise West of Cascadia, LLC | Skilled Nursing Facility | 8211 Ustick Road, Boise, ID 83704-5756 | 2016-08-11 |
1861946436 | Bellevue of Cascadia, LLC | Skilled Nursing Facility | 620 N. 6th Street, Bellevue, ID 83313 | 2016-08-11 |
1437603008 | Twin Falls of Cascadia, LLC | Skilled Nursing Facility | 674 Eastland Drive, Twin Falls, ID 83301-6846 | 2016-08-11 |
1235683806 | Payette of Cascadia, LLC | Skilled Nursing Facility | 1019 3rd Avenue South, Payette, ID 83661-2832 | 2016-08-11 |
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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.