VISTA HEALTHCARE PC (NPI# 1720502370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720502370 |
| Entity Type | Organization |
| Organization Name | VISTA HEALTHCARE PC |
| Practice Address |
556 Trejo St Ste B Rexburg ID 83440-2626 |
| Mailing Address |
556 Trejo Street Suite B Rexburg ID 83440-2625 |
| Practice Telephone | 2083516981 |
| Mailing Telephone | 2083516981 |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-11-17 |
| Authorized Official Name | RACHELLE JONES (PRESIDENT) |
| Authorized Official Telephone | 2088810902 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | NP-914A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP-914A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NP-914A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
NP-914A | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
NP-914A | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1982830345 | 05 |
| Street Address |
556 TREJO ST STE B |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982830345 | Rachelle Jones | Nurse Practitioner | 556 Trejo St Ste B, Rexburg, ID 83440-2626 | 2009-05-29 |
| 1902429392 | Marquee Gale Ricks | Nurse Practitioner | 556 Trejo St Ste B, Rexburg, ID 83440-2626 | 2020-05-20 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346643038 | Madison Memorial Hospital | Clinic/Center | 450 E Main St, Rexburg, ID 83440-2048 | 2014-10-08 |
| 1285700377 | Rexburg Family Medical Center, Pllc | Clinic/Center | 1 Professional Plz, Rexburg, ID 83440-2024 | 2006-11-28 |
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| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1447801451 | Mountain Country Family Healthcare, Pllc | Clinic/Center | 31911 N 5th Ave, Spirit Lake, ID 83869 | 2019-09-23 |
| 1275186835 | Bella Family Healthcare & Aesthetics | Clinic/Center | 1545 E Leighfield Dr Ste 100, Meridian, ID 83646-5371 | 2019-07-22 |
| 1902387285 | Integrative Health Solutions Pllc | Clinic/Center | 1215 Michigan St Ste B, Sandpoint, ID 83864-5014 | 2018-08-24 |
| 1235618331 | Healthworks Med Group of Colorado P C | Clinic/Center | 126 E 21st St, Burley, ID 83318-2551 | 2018-08-09 |
| 1427537927 | Gem State Family Health Care Pllc | Clinic/Center | 496 Shoup Ave W Ste E, Twin Falls, ID 83301-5043 | 2018-08-07 |
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1073031118 | Clover Creek Medical | Clinic/Center | 175 North Main Street, Bloomington, ID 83223-8322 | 2017-09-08 |
| 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.