TETON RADIOLOGY MADISON LLC (NPI# 1407081060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407081060 |
| Entity Type | Organization |
| Organization Name | TETON RADIOLOGY MADISON LLC |
| Practice Address |
425 E 4th N Rexburg ID 83440-5390 |
| Mailing Address |
Po Box 3007 Idaho Falls ID 83403-3007 |
| Practice Telephone | 2083564888 |
| Mailing Telephone | 2085528772 |
| Mailing Fax Number | 2085232025 |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2015-01-10 |
| Authorized Official Name | JOHN J STROBEL (VP) |
| Authorized Official Telephone | 2085425000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| Street Address |
425 E 4TH N |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-5390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768490 | Henry's Fork Surgery Center Pllc | Clinic/Center | 23 Sawtelle Ave, Rexburg, ID 83440 | 2020-04-08 |
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| Find all providers in zip 83440 | ||||
| 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 |
| 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 |
| 1194969725 | Teton Radiology Diagnostic, LLC | Radiology | 2001 S Woodruff Ave Ste 17, Idaho Falls, ID 83404-6372 | 2009-04-27 |
| 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 |
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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.