IMAGING CENTER OF IDAHO, LLC (NPI# 1659528511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659528511 |
| Entity Type | Organization |
| Organization Name | IMAGING CENTER OF IDAHO, LLC |
| Practice Address |
4519 Enterprise Way Caldwell ID 83605-8086 |
| Mailing Address |
Po Box 4813 Boise ID 83711-4813 |
| Practice Telephone | 2084557482 |
| Practice Fax Number | 2084557538 |
| Mailing Telephone | 2084557482 |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2009-01-12 |
| Authorized Official Name | MR. GREGORY F. CLARK (CEO) |
| Authorized Official Telephone | 2084557482 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801090204 | Imaging Center of Idaho, LLC | Radiologic Technologist | 4519 Enterprise Wy, Caldwell, ID 83605-9999 | 2007-06-12 |
| Street Address |
4519 ENTERPRISE WAY |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-8086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821280371 | Mountain Telerad, Pllc | Radiologic Technologist | 4519 Enterprise Way, Caldwell, ID 83605 | 2007-08-17 |
| 1447402425 | Christopher James Malcom | Radiology | 4519 Enterprise Way, Caldwell, ID 83605-8055 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699175158 | Allied Imaging Inc | Clinic/Center | 2043 E Center St Ste 115, Pocatello, ID 83201-3300 | 2014-09-02 |
| 1982042693 | Alliance Healthcare Services Inc | Clinic/Center | 3581 E Overland Rd, Meridian, ID 83642-6757 | 2013-06-05 |
| 1316003726 | Advanced Open Imaging Boise LLC | Clinic/Center | 3581 East Overland Rd, Meridian, ID 83642 | 2006-12-29 |
| 1437178399 | Idaho Facial Imaging LLC | Clinic/Center | 8119 Ustick Rd, Suite 101, Boise, ID 83704-5754 | 2006-07-19 |
| 1053305144 | Teton Mri of Idaho Falls | Clinic/Center | 2060 S Woodruff Ave, Idaho Falls, ID 83404-6396 | 2005-09-06 |
| 1982037107 | Sjrmc Interventional Radiology Services LLC | Clinic/Center | 415 6th St, Lewiston, ID 83501-2431 | 2013-08-12 |
| 1326230590 | Cassia Physicians Billing | Clinic/Center | 1501 Hiland Ave, Burley, ID 83318-2682 | 2007-08-13 |
| 1508991373 | Not-tsoo Gah-nee Indiane Health Services | Clinic/Center | Mission Road, Fort Hall, ID 83203 | 2007-02-22 |
| 1669483509 | Twin Falls Imaging and Diagnostic Center | Clinic/Center | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-08-09 |
| 1629031760 | Swient, LLC | Clinic/Center | 900 N Liberty St, Suite 305, Boise, ID 83704-8704 | 2006-04-10 |
| 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.