PORTNEUF MEDICAL CENTER (NPI# 1578505335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578505335 |
| Entity Type | Organization |
| Organization Name | PORTNEUF MEDICAL CENTER |
| Other Organization Name | POCATELLO (ISU) FAMILY MEDICINE |
| Practice Address |
651 Memorial Dr Pocatello ID 83201-4071 |
| Practice Telephone | 2082824700 |
| Practice Fax Number | 2082824969 |
| Mailing Telephone | 2082824700 |
| Mailing Fax Number | 2082824969 |
| 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 | 261Q00000X | Clinic/Center | H12 | ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Pocatello (ISU) Family Medicine | 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 |
| 1437191418 | Portneuf Medical Center | Pharmacist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
| 1326080599 | Portneuf Medical Center | Skilled Nursing Facility | 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 |
| Find all providers in the same location | ||||
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376083568 | Patriot Healthcare, LLC | Clinic/Center | 144 Oasis Dr, Pocatello, ID 83204-4826 | 2017-03-07 |
| 1922257823 | Michael R Flandro Od Pa | Clinic/Center | 360 S Arthur Ave, Pocatello, ID 83204-3307 | 2008-09-16 |
| 1740632942 | Bmh Inc | Clinic/Center | 353 N 4th Ave, Suite 102, Pocatello, ID 83201-6390 | 2016-07-12 |
| 1417216961 | Community Mental Health Services | Clinic/Center | 720 E Lander St, Pocatello, ID 83201-6228 | 2012-05-03 |
| 1205025673 | Bmh Inc | Clinic/Center | 1151 Hospital Way, Pocatello, ID 83201-5091 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992323216 | Wolf Pack LLC | Clinic/Center | 939 S 25th E Ste 115, Ammon, ID 83406-5736 | 2020-07-13 |
| 1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
| 1164072187 | Peter John Leichtnam | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-12 |
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
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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.