| Idaho Physician Services Inc. | |
|
3200 Channing Way Ste A205 Idaho Falls ID 83404-7586 | |
| (208) 535-4580 | |
| (208) 535-4520 |
| Full Name | Idaho Physician Services Inc. |
|---|---|
| Speciality | Orthopaedic Surgery |
| Location | 3200 Channing Way Ste A205, Idaho Falls, Idaho |
| Authorized Official Name and Position | Louis Joseph (VP) |
| Authorized Official Contact | 6153737630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Physician Services Inc. 2000 Health Park Dr Brentwood TN 37027-4525 Ph: (615) 373-7600 | Idaho Physician Services Inc. 3200 Channing Way Ste A205 Idaho Falls ID 83404-7586 Ph: (208) 535-4580 |
| NPI Number | 1902841893 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 01/02/2023 |
| Certification Date | 01/02/2023 |
| Medicare PECOS PAC ID | 2163430943 |
|---|---|
| Medicare Enrollment ID | O20070208000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902841893 | NPI | - | NPPES |
| 000010154957 | Other | ID | BLUE SHIELD |
| 1902841893 | Medicaid | WY | |
| 1902841893 | Medicaid | MT | |
| 807418100 | Medicaid | ID | |
| 8M826 | Other | ID | BLUECROSS OF ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 207X00000X | Orthopaedic Surgery | (* (Not Available)) | Primary |
| Provider Name | Adrian Curnow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750430617 PECOS PAC ID: 0941390637 Enrollment ID: I20071218000559 |
| Provider Name | Benjamin B Garner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497913008 PECOS PAC ID: 6103970355 Enrollment ID: I20090821000499 |
| Provider Name | Heike Wallin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841469004 PECOS PAC ID: 7911173307 Enrollment ID: I20120106000273 |
| Provider Name | Brandon Reyes Kelly |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295942142 PECOS PAC ID: 1759550429 Enrollment ID: I20120807000268 |
| Provider Name | Michael L Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316288665 PECOS PAC ID: 1456590694 Enrollment ID: I20130618000851 |
| Provider Name | Edward R Setser |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1013977297 PECOS PAC ID: 6406807841 Enrollment ID: I20150302000015 |
| Provider Name | Matthew Taylor |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1033123658 PECOS PAC ID: 8022922905 Enrollment ID: I20150707003340 |
| Provider Name | John T Bagwell |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1598783128 PECOS PAC ID: 4385640176 Enrollment ID: I20171020001002 |
| Provider Name | Lance Glen Jacobson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689940405 PECOS PAC ID: 7517185499 Enrollment ID: I20181024000126 |
| Provider Name | Jacob W Wendling |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861788937 PECOS PAC ID: 4981972650 Enrollment ID: I20191106003020 |
| Provider Name | Logan Daniel Cutts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144661752 PECOS PAC ID: 1951545193 Enrollment ID: I20200507001185 |
| Provider Name | Amy Diana Thornley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396097630 PECOS PAC ID: 8729489810 Enrollment ID: I20210628000303 |
| Provider Name | Shannielle Louise Baird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376068759 PECOS PAC ID: 2668873605 Enrollment ID: I20210628002137 |
| Provider Name | Jacklyn Lea Hagg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861928111 PECOS PAC ID: 4183995202 Enrollment ID: I20210923001103 |
| Provider Name | Denis Raleigh |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1427069855 PECOS PAC ID: 0941219497 Enrollment ID: I20230105001907 |
| Provider Name | David Jon Pombo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588720783 PECOS PAC ID: 0345316105 Enrollment ID: I20230215001541 |
| Provider Name | David Joyce |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1558416115 PECOS PAC ID: 1254308018 Enrollment ID: I20230221003063 |
| Provider Name | Abraham Carl Schlauderaff |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1225492390 PECOS PAC ID: 8820456064 Enrollment ID: I20230621001856 |
| Provider Name | Joyce L Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952503781 PECOS PAC ID: 2264663483 Enrollment ID: I20230706001638 |
| Provider Name | William Joseph Hammond |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346582137 PECOS PAC ID: 8123550514 Enrollment ID: I20241009004312 |
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 |