| Carepoint Inpatient Blue Sky Neurology Idaho, Llc | |
|
3100 Channing Way Idaho Falls ID 83404-7533 | |
| (208) 529-6111 | |
| Not Available |
| Full Name | Carepoint Inpatient Blue Sky Neurology Idaho, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3100 Channing Way, Idaho Falls, Idaho |
| Authorized Official Name and Position | Deborah Smith (VICE PRESIDENT/GENERAL COUNSEL) |
| Authorized Official Contact | 3034780430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carepoint Inpatient Blue Sky Neurology Idaho, Llc 5600 S Quebec St Ste 312a Greenwood Vlg CO 80111-2208 Ph: (303) 436-2720 | Carepoint Inpatient Blue Sky Neurology Idaho, Llc 3100 Channing Way Idaho Falls ID 83404-7533 Ph: (208) 529-6111 |
| NPI Number | 1992379507 |
|---|---|
| Provider Enumeration Date | 05/18/2021 |
| Last Update Date | 12/21/2021 |
| Certification Date | 12/21/2021 |
| Medicare PECOS PAC ID | 6103224936 |
|---|---|
| Medicare Enrollment ID | O20211008002252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992379507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Jeffrey C Wagner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033321914 PECOS PAC ID: 2769580075 Enrollment ID: I20170829003090 |
| Provider Name | Christopher Vincent Fanale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598776452 PECOS PAC ID: 6103803465 Enrollment ID: I20171009002118 |
| Provider Name | Alicia Erin Bennett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023317633 PECOS PAC ID: 6002033370 Enrollment ID: I20171211002677 |
| Provider Name | William L Hills |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609080886 PECOS PAC ID: 6507957313 Enrollment ID: I20220315001539 |
| Provider Name | Brian L Stucki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588867477 PECOS PAC ID: 8022173533 Enrollment ID: I20220613002303 |
| Provider Name | Gurjeet Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780947937 PECOS PAC ID: 8224261763 Enrollment ID: I20221215002443 |
| Provider Name | David Harris Delman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669764924 PECOS PAC ID: 4082833926 Enrollment ID: I20230220000355 |
| Provider Name | Shahzaib Tariq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851943039 PECOS PAC ID: 8729445143 Enrollment ID: I20230530003324 |
Sullivan Mental Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-523-1558 Fax: 208-529-4788 | |
Ashton Memorial, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2935 Rollandet St, Idaho Falls, ID 83402 Phone: 208-542-2905 Fax: 208-522-2427 | |
Independence, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1230 N Skyline Dr, Ste. A, Idaho Falls, ID 83402 Phone: 208-524-0881 Fax: 208-524-0886 | |
Life Quest Family Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 586 1st St, Idaho Falls, ID 83401 Phone: 208-529-2920 | |
Access Point Family Sevices Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2680 Channing Way, Idaho Falls, ID 83404 Phone: 208-522-4026 Fax: 208-522-4138 | |
Integrated Family & Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3355 S Holmes Ave, Idaho Falls, ID 83404 Phone: 208-523-2080 Fax: 208-523-2799 | |
Childrens Supportive Services Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1565 E Lincoln Rd, Idaho Falls, ID 83401 Phone: 208-524-8996 Fax: 208-524-1205 |