TETON VALLEY HEALTH CARE, INC (NPI# 1801143029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801143029 |
Entity Type | Organization |
Organization Name | TETON VALLEY HEALTH CARE, INC |
Other Organization Name | VICTOR CLINIC |
Practice Address |
83 N Main St Victor ID 83455-0368 |
Mailing Address |
120 E Howard St Driggs ID 83422-5112 |
Practice Telephone | 2083546307 |
Practice Fax Number | 2087877456 |
Mailing Telephone | 2083546302 |
Mailing Fax Number | 2083543158 |
Enumeration Date | 2012-08-07 |
Last Update Date | 2020-02-20 |
Authorized Official Name | JILL PAYNE PAYNE (CHIEF OF COMPLIANCE) |
Authorized Official Telephone | 2083546352 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
ID | Allopathic & Osteopathic Physicians | |
N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
ID | Physician Assistants & Advanced Practice Nursing Providers | |
N | 207Q00000X | Family Medicine | ID | Allopathic & Osteopathic Physicians | |
N | 207X00000X | Orthopaedic Surgery | ID | Allopathic & Osteopathic Physicians | |
N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
ID | Allopathic & Osteopathic Physicians | |
N | 208000000X | Pediatrics | ID | Allopathic & Osteopathic Physicians | |
N | 208600000X | Surgery | 31 | ID | Allopathic & Osteopathic Physicians |
N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
31 | ID | Allopathic & Osteopathic Physicians |
N | 363AM0700X |
Physician Assistant Specialization: Medical |
ID | Physician Assistants & Advanced Practice Nursing Providers | |
N | 363L00000X | Nurse Practitioner | ID | Physician Assistants & Advanced Practice Nursing Providers | |
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
31 | ID | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Victor Clinic | Doing Business As Name - Organization |
Victor Health Clinic | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053669598 | Teton Valley Health Care, Inc | General Acute Care Hospital | 120 E Howard Avenue, Driggs, ID 83422-5112 | 2012-08-15 |
Street Address |
83 N MAIN ST |
City | VICTOR |
State | ID |
Zip Code | 83455-0368 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376050385 | Hunters Inc | Pharmacy | 81 N. Main St., Victor, ID 83455 | 2017-12-29 |
1194109306 | Emily Williams | Occupational Therapist | 73 N Main Street, Victor, ID 83455 | 2015-07-17 |
1073918173 | Teton Valley Vision PC | Optometrist | 7389 S Hwy 33, Ste B, Victor, ID 83455 | 2014-10-31 |
1437440591 | Nathan Richard George | Dentist | 7726 Lupine Lane, Victor, ID 83455 | 2011-04-25 |
1245537695 | Erin N Borbet | Acupuncturist | 108 W Center St Unit 3, Victor, ID 83455 | 2011-02-22 |
1336457837 | Grand Teton Dental Care | Clinic/Center | 741 South 50 West, Suite A, Victor, ID 83455 | 2010-09-17 |
1598086126 | Childs Play, LLC | Speech-Language Pathologist | 73 North Main, Victor, ID 83455 | 2010-06-17 |
1891025656 | Phillips Therapy Incorporated | Occupational Therapist | 73 North Main St., Suite 3, Victor, ID 83455 | 2009-12-30 |
1861621278 | Elmer Raymond Cherry Iv | Dentist | 7389 S. Hwy. 33 Suite A, Victor, ID 83455 | 2009-07-07 |
1861534133 | Amy Herzog | Counselor | 175 Brome Dr., #7, Victor, ID 83455 | 2007-02-13 |
Find all providers in zip 83455 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
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---|---|---|---|---|
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1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
1700206588 | Mvh Bmc LLC | Clinic/Center | 210 S Emerson Ave, Shelley, ID 83274-1229 | 2014-04-21 |
1922243088 | Bmh Inc | Clinic/Center | 1355 Parkway Dr, Blackfoot, ID 83221-1656 | 2008-12-03 |
1023271731 | Upper Valley Family Medicine Rhc | Clinic/Center | 530 Rigby Lake Dr, Rigby, ID 83442-1271 | 2008-07-03 |
1891984167 | Bmh Inc | Clinic/Center | 1425 Parkway Drive, Blackfoot, ID 83221-1758 | 2007-10-23 |
1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
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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.