IDAHO PHYSICIAN SERVICES INC. (NPI# 1902841893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902841893 |
| Entity Type | Organization |
| Organization Name | IDAHO PHYSICIAN SERVICES INC. |
| Other Organization Name | EAST FALLS ORTHOPEDICS |
| Practice Address |
3200 Channing Way Ste A205 Idaho Falls ID 83404-7586 |
| Mailing Address |
2000 Health Park Dr Brentwood TN 37027-4525 |
| Practice Telephone | 2085354580 |
| Practice Fax Number | 2085354520 |
| Mailing Telephone | 6153737600 |
| Mailing Fax Number | 8663461426 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | WILLIAM TEDRICK JOHNSON (GROUP VP/AO) |
| Authorized Official Telephone | 6153723375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807418100 | 05 | |
| WY | 1902841893 | 05 | |
| ID | BLUE SHIELD | 000010154957 | 01 |
| MT | 1902841893 | 05 | |
| ID | BLUECROSS OF ID | 8M826 | 01 |
| Other Name | Type Code |
|---|---|
| East Falls Orthopedics | Doing Business As Name - Organization |
| Street Address |
3200 CHANNING WAY STE A205 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679528632 | Duncan Dwaynne Harris | Urology | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2006-05-24 |
| 1811372410 | Logan Cooper | Orthopaedic Surgery | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2015-07-23 |
| 1689940405 | Lance Glen Jacobson | Orthopaedic Surgery | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2012-03-26 |
| 1205121498 | Terry L Thompson | Nurse Practitioner | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2011-06-15 |
| 1598783128 | John Todd Bagwell | Internal Medicine | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497913008 | Benjamin B Garner | Orthopaedic Surgery | 3200 Channing Way Ste 205a, Idaho Falls, ID 83404-7586 | 2008-05-30 |
| 1730297706 | Philip R Mccowin | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-29 |
| 1932136512 | Casey I Huntsman | Orthopaedic Surgery | 3300 Washington Parkway, Idaho Falls, ID 83404-7592 | 2006-06-27 |
| 1629060280 | John L Andary | Orthopaedic Surgery | 2035 E 17th St, Idaho Falls, ID 83404-6430 | 2005-08-19 |
| 1710985551 | Robert Jensen Lee | Orthopaedic Surgery | 3446 S 15th E, Idaho Falls, ID 83404-8262 | 2005-07-13 |
| 1528683059 | Mennear Orthopedics LLC | Orthopaedic Surgery | 3300 Washington Pkwy, Idaho Falls, ID 83404-7592 | 2020-06-10 |
| 1295189918 | East Idaho Orthopaedics Pllc | Orthopaedic Surgery | 3405 Merlin Dr, Idaho Falls, ID 83404-7430 | 2016-04-19 |
| 1811372410 | Logan Cooper | Orthopaedic Surgery | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2015-07-23 |
| 1356785018 | Huntsman & Dalling Orthopedics Pllc | Orthopaedic Surgery | 3300 Washington Parkway, Idaho Falls, ID 83404-7592 | 2013-04-24 |
| 1992067722 | Brandon David Mennear | Orthopaedic Surgery | 3300 Washington Pkwy, Idaho Falls, ID 83404 | 2012-06-07 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.