NORTH CANYON JEROME CLINIC (NPI# 1376160457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376160457 |
| Entity Type | Organization |
| Organization Name | NORTH CANYON JEROME CLINIC |
| Practice Address |
491 Heritage Dr Jerome ID 83338-6701 |
| Mailing Address |
267 N Canyon Dr Gooding ID 83330-5500 |
| Practice Telephone | 2086447500 |
| Practice Fax Number | 2086447501 |
| Mailing Telephone | 2089344433 |
| Mailing Fax Number | 2089348643 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | SARA DEMOE (CFO) |
| Authorized Official Telephone | 2089349695 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH CANYON MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| North Canyon Jerome Clinic | Doing Business As Name - Organization |
| Street Address |
491 HERITAGE DR |
| City | JEROME |
| State | ID |
| Zip Code | 83338-6701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
| 1811391626 | Summit Therapy Services | In Home Supportive Care | 113 East Ave. F, Jerome, ID 83338 | 2014-10-22 |
| 1952645285 | Readings Community Pharmacy Inc | Pharmacy | 133 West A, Jerome, ID 83338 | 2012-11-27 |
| 1801121298 | Yolanda S. Sedano | Physician Assistant | 132 5th Ave West, Jerome, ID 83338 | 2009-10-02 |
| 1295898310 | Ronald Gail Hendrickson | Dentist | 128 South Adams, Jerome, ID 83338 | 2006-12-19 |
| 1316035512 | Johnson Chiropractic Clinic | Chiropractor | 600 N Lincoln Ave, Jerome, ID 83338 | 2006-10-11 |
| 1265527725 | Lon M. Egbert, P.C. | Specialist/Technologist | 128 5th Ave West, Jerome, ID 83338 | 2006-10-03 |
| 1992898605 | St Benedicts Family Medical Center | Home Health | 414 N Lincoln, Suite 1, Jerome, ID 83338 | 2006-10-02 |
| 1790231355 | Lexa Marie Balling | Pharmacist | 2680 S Lincoln Ave, Jerome, ID 83338 | 2016-09-01 |
| 1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
| Find all providers in zip 83338 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063970143 | Idaho Street Medical Clinic | Clinic/Center | 126 Idaho Ave., Homedale, ID 83628-8362 | 2019-03-07 |
| 1568950566 | North Canyon Medical Center, Inc. | Clinic/Center | 718 Hwy 30, Buhl, ID 83316 | 2018-04-25 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1700206588 | Mvh Bmc LLC | Clinic/Center | 210 S Emerson Ave, Shelley, ID 83274-1229 | 2014-04-21 |
| 1922243088 | Bmh Inc | Clinic/Center | 1355 Parkway Dr, Blackfoot, ID 83221-1656 | 2008-12-03 |
| 1023271731 | Upper Valley Family Medicine Rhc | Clinic/Center | 530 Rigby Lake Dr, Rigby, ID 83442-1271 | 2008-07-03 |
| 1891984167 | Bmh Inc | Clinic/Center | 1425 Parkway Drive, Blackfoot, ID 83221-1758 | 2007-10-23 |
| 1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
| 1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
| 1245267467 | Hti Physican Services of Utah,inc | Clinic/Center | 124 5th Street, Suite A, Wilder, ID 83676-0037 | 2006-06-26 |
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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.