NORTH CANYON MEDICAL CENTER, INC. (NPI# 1619469525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619469525 |
| Entity Type | Organization |
| Organization Name | NORTH CANYON MEDICAL CENTER, INC. |
| Other Organization Name | MEDICARE DIABETIC PREVENTION PROGRAM |
| Practice Address |
267 N Canyon Dr Gooding ID 83330-5500 |
| Practice Telephone | 2089349886 |
| Practice Fax Number | 2087353718 |
| Mailing Telephone | 2089349886 |
| Mailing Fax Number | 2087353718 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | TIMOTHY L POWERS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2089348765 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH CANYON MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174H00000X | Health Educator | ID | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Medicare Diabetic Prevention Program | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1275703241 | North Canyon Medical Center, Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH CANYON MEDICAL CENTER, INC. | 267 N Canyon Dr, Gooding, ID 83330-5500 |
| Street Address |
267 N CANYON DR |
| City | GOODING |
| State | ID |
| Zip Code | 83330-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053316786 | Guy Eric Grooms | Specialist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2005-06-17 |
| 1841800943 | Charles Bryan Simpson | Emergency Medical Technician, Paramedic | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2020-08-04 |
| 1871098137 | Amanda Paige Braga | Social Worker | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-28 |
| 1497259378 | Francisca O Mendez | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-23 |
| 1740783125 | Susan A. Ormond | Dietitian, Registered | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| 1538662895 | Mercedes Diaz | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| 1255834685 | Rosa Yuriko Saucedo | Nurse's Aide | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1235632662 | Anali Santos | Nurse's Aide | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1083117402 | Tammy Jo Dayley | Technician/Technologist | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-12 |
| 1922506146 | Merri Ann King | Registered Nurse | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1083959332 | Lydia Jo Missal | Counselor | 1832 E. 1750 S., Gooding, ID 83330 | 2012-11-27 |
| 1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
| 1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
| 1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
| 1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
| 1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
| 1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| Find all providers in zip 83330 | ||||
| Taxonomy Code | 174H00000X |
| Grouping | Other Service Providers |
| Classification | Health Educator |
| Health educators work in a variety of settings providing education to individuals or groups of individuals on healthy behaviors, wellness, and health-related topics with the goal of preventing diseases and health problems. Health educators generally require a bachelor’s degree and may receive additional training, such as through mentoring, internships, or volunteer work. |
| Notes: Source: National Uniform Claim Committee, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497259378 | Francisca O Mendez | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-23 |
| 1538662895 | Mercedes Diaz | Health Educator | 267 N Canyon Dr, Gooding, ID 83330-5500 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457990194 | Lisa Scoffield | Health Educator | 11810 N Tracey Rd, Hayden, ID 83835-9864 | 2019-12-28 |
| 1861045171 | Donna Lousie Bywater | Health Educator | 1751 Elizabeth Blvd, Twin Falls, ID 83301-6938 | 2019-07-17 |
| 1730731407 | Katy Touchette | Health Educator | 203 Main Ave E, Twin Falls, ID 83301-6230 | 2019-07-12 |
| 1205495371 | Aaa American Healthcare LLC | Health Educator | 665 John Adams Pkwy, Idaho Falls, ID 83401-4072 | 2019-06-11 |
| 1508307315 | Laurel Bake | Health Educator | 106 E 3rd St Ste 3b, Moscow, ID 83843-2970 | 2017-03-13 |
| 1730636358 | Tkj, LLC | Health Educator | 1251 Arrowhead Plaza Way, Driggs, ID 83422 | 2016-09-01 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1902268527 | Marni Marie Henderson | Health Educator | 6393 S Red Shine Way, Boise, ID 83709-6509 | 2016-03-23 |
| 1578947339 | Tyler Watson | Health Educator | 354 Oaktrail Dr, Rexburg, ID 83440-2575 | 2015-07-11 |
| 1881095248 | Ellen Wait | Health Educator | 8262 N Wayne Dr, Hayden, ID 83835-5029 | 2014-09-04 |
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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.