MOUNTAIN FALLS MEDICAL LLC (NPI# 1932526373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932526373 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN FALLS MEDICAL LLC |
| Practice Address |
1995 E 17th St Idaho Falls ID 83404-6493 |
| Mailing Address |
1034 E 800 N Shelley ID 83274-5304 |
| Practice Telephone | 2084032107 |
| Mailing Telephone | 2084032107 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |
| Authorized Official Name | MRS. CAULEEN MARIE STRADLING (OWNER) |
| Authorized Official Telephone | 2084032107 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1995 E 17TH ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-6493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738797 | Eric A Wingerson | Internal Medicine | 1995 E 17th St, St. #4, Idaho Falls, ID 83404-6493 | 2005-05-27 |
| 1609492347 | Jason T Rinker | Physician Assistant | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2020-06-18 |
| 1942836911 | Amerihealth Inc | Psychologist | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2020-03-20 |
| 1730652280 | Brandy Lee Larson | Nurse Practitioner | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2019-01-08 |
| 1104320324 | Daniel Joseph Barney | Nurse Practitioner | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2018-03-21 |
| 1962919662 | Derek Richard Whitmill | Nurse Practitioner | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2018-01-03 |
| 1134647019 | Randall James Law | Physician Assistant | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2017-08-31 |
| 1417498890 | Kara Dee Boll | Nurse Practitioner | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2017-03-17 |
| 1205179751 | Jacob Wayne Moss | General Practice | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2013-04-03 |
| 1376852053 | Kirsten A Davis | Massage Therapist | 1995 E 17th St, Suite 2, Idaho Falls, ID 83404-6493 | 2010-09-29 |
| Find all providers in the same location | ||||
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386167492 | Christy Taylor | Nurse Practitioner | 1327 E 17th Street, Idaho Falls, ID 83404-8340 | 2017-07-20 |
| 1912378787 | Aaa American Healthcare LLC | Nurse Practitioner | 1301 E 17th St Ste 5, Idaho Falls, ID 83404-6273 | 2015-10-19 |
| 1316288665 | Michael L Parsons | Nurse Practitioner | 3200 Channing Way Ste 306, Idaho Falls, ID 83404-7546 | 2013-03-12 |
| 1578780961 | Lisa J Zajanc | Nurse Practitioner | 2860 Channing Way Ste 224, Idaho Falls, ID 83404-7541 | 2007-04-19 |
| 1629128483 | Victoria L Blair | Nurse Practitioner | 2001 S Woodruff Ave Ste 15b, Idaho Falls, ID 83404-6372 | 2007-01-11 |
| 1063446094 | Sally Kupchock | Nurse Practitioner | 1182 E 21st St, Idaho Falls, ID 83404-7003 | 2006-07-10 |
| 1487623179 | Heather A Stolworthy | Nurse Practitioner | 2770 Cortez Ave, Idaho Falls, ID 83404-7590 | 2006-03-15 |
| 1417957176 | Janet Susan Garland | Nurse Practitioner | 3302 Valencia Dr, Suite 201, Idaho Falls, ID 83404 | 2005-07-26 |
| 1720628308 | Juliette Ann Hollingshead | Nurse Practitioner | 2985 Cortez Ave, Idaho Falls, ID 83404-7554 | 2020-01-10 |
| 1427600501 | Ryan Englis | Nurse Practitioner | 1957 E 17th St, Idaho Falls, ID 83404-6429 | 2019-07-10 |
| 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.