Christopher A Heatherton (NPI# 1972626786, PAC ID# 1052489242) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1972626786 |
| PAC ID by PECOS | 1052489242 |
| Professional Enrollment ID | I20160921002887 |
| Full Name | Christopher A Heatherton |
| Organization Legal Name | LOST RIVERS MEDICAL CENTER |
| Address |
551 Highland Dr Arco ID 83213-5003 |
| Phone Number | 2082527654 |
| Gender | M |
| Medical School | UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE |
| Graduation Year | 2005 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7810807427 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131325 | BINGHAM MEMORIAL HOSPITAL |
| 131324 | LOST RIVERS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 551 Highland Dr, Arco, ID 83213-5003 | 2082527654 | LOST RIVERS MEDICAL CENTER |
| 98 Poplar St, Blackfoot, ID 83221-1758 | 2087823993 | BMH INC |
| 1595 Bannock Hwy, Pocatello, ID 83204-3509 | 2084782449 | BMH INC |
| Organization Legal Name | LOST RIVERS MEDICAL CENTER |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary B Spraktes | Nurse Practitioner | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Jenna Lee Jensen | Nurse Practitioner | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Helen M Merrill | Chiropractic | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Street Address |
551 HIGHLAND DR |
| City | ARCO |
| State | ID |
| Zip | 83213-5003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cody E Jones | Optometry | 551 Highland Dr, Arco, ID 83213-5003 | |
| Mary B Spraktes | Nurse Practitioner | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Jenna Lee Jensen | Nurse Practitioner | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Helen M Merrill | Chiropractic | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald Sebreros | Clinical Social Worker | Mental Wellness Centers, Inc | 159 N Idaho St, Arco, ID 83213-4708 |
| City | ARCO |
| Zip Code | 83213 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ARCO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Christopher A Heatherton.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.