ENDOSCOPY CENTER, LLC (NPI# 1770502767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770502767 |
| Entity Type | Organization |
| Organization Name | ENDOSCOPY CENTER, LLC |
| Practice Address |
1151 Hospital Way Bldg A Pocatello ID 83201-2763 |
| Mailing Address |
Po Box 4788 Pocatello ID 83205-4788 |
| Practice Telephone | 2082326616 |
| Practice Fax Number | 2082326618 |
| Mailing Telephone | 2082326616 |
| Mailing Fax Number | 2082326618 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS VANCE DAVIS (MEMBER) |
| Authorized Official Telephone | 2082326616 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902831225 | Endoscopy Center, LLC | Clinic/Center | 13421 Old Meridian St, Carmel, IN 46032-1427 | 2006-07-12 |
| 1427003821 | Endoscopy Center, LLC | Clinic/Center | 13421 Old Meridian St, Carmel, IN 46032-1427 | 2006-05-23 |
| Street Address |
1151 HOSPITAL WAY BLDG A |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295754265 | Southeast Idaho Gastroenterology,pllc | Internal Medicine | 1151 Hospital Way Bldg A, Pocatello, ID 83201-2763 | 2006-07-19 |
| 1073022778 | Kimberly Dolecheck Tverdy | Physician Assistant | 1151 Hospital Way Bldg A, Pocatello, ID 83201-5091 | 2017-09-25 |
| 1871016071 | Portneuf Asc, LLC | Clinic/Center | 1151 Hospital Way Bldg A, Pocatello, ID 83201-5091 | 2017-07-19 |
| 1710358007 | Matthew Gregson | Physician Assistant | 1151 Hospital Way Bldg A, Pocatello, ID 83201-5091 | 2015-10-12 |
| 1114028354 | Shad Carl Johnson | Physician Assistant | 1151 Hospital Way Bldg A, Pocatello, ID 83201-2763 | 2006-09-26 |
| 1972525111 | Darryl Bruce Cook | Internal Medicine | 1151 Hospital Way Bldg A, Pocatello, ID 83201-2763 | 2006-07-24 |
| 1295757433 | Thomas Vance Davis | Internal Medicine | 1151 Hospital Way Bldg A, Pocatello, ID 83201-2763 | 2006-07-24 |
| 1992727143 | Charles Barclay Evans | Internal Medicine | 1151 Hospital Way Bldg A, Pocatello, ID 83201-2763 | 2006-07-24 |
| 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 | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669410361 | Snake River Gastroenterology Labs, L.L.C. | Clinic/Center | 141 Morrison St, Twin Falls, ID 83301-5451 | 2006-06-03 |
| 1437148004 | Lewis Clark Endoscopy, Pllc | Clinic/Center | 1630 23rd Ave, Suite 801, Lewiston, ID 83501-6345 | 2005-10-17 |
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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.