| 4 Pillars Of Success Llc | |
|
1675 Curlew Dr Ammon ID 83406-4718 | |
| (208) 523-5319 | |
| Not Available |
| Full Name | 4 Pillars Of Success Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1675 Curlew Dr, Ammon, Idaho |
| Authorized Official Name and Position | Demi Echi-aboli (BILLING DEPARTMENT DIRECTOR) |
| Authorized Official Contact | 2083601038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 Pillars Of Success Llc Po Box 2106 Idaho Falls ID 83403-2106 Ph: (208) 523-5319 | 4 Pillars Of Success Llc 1675 Curlew Dr Ammon ID 83406-4718 Ph: (208) 523-5319 |
| NPI Number | 1619134277 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 02/19/2025 |
| Medicare PECOS PAC ID | 3173794187 |
|---|---|
| Medicare Enrollment ID | O20110923000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619134277 | NPI | - | NPPES |
| 1619134277 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Brett L Hampton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053683904 PECOS PAC ID: 3971739863 Enrollment ID: I20131125000854 |
| Provider Name | April A Moedl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225346190 PECOS PAC ID: 0446480685 Enrollment ID: I20140307000973 |
| Provider Name | Jefferson H Kraczek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093087033 PECOS PAC ID: 8325266505 Enrollment ID: I20140829001772 |
| Provider Name | Kathryn E Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619416674 PECOS PAC ID: 5890062699 Enrollment ID: I20170526001920 |
| Provider Name | David C Homer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649336488 PECOS PAC ID: 6709159650 Enrollment ID: I20170829002042 |
| Provider Name | Tanner M Nielsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346574464 PECOS PAC ID: 0941568547 Enrollment ID: I20180102001770 |
| Provider Name | David Paul Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417443631 PECOS PAC ID: 6507118577 Enrollment ID: I20181003001014 |
| Provider Name | Kristy D Goodson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194156216 PECOS PAC ID: 2163765942 Enrollment ID: I20190517001629 |
| Provider Name | Johnathan Koelsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326409913 PECOS PAC ID: 9931442696 Enrollment ID: I20190521000295 |
| Provider Name | Whitney L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770150484 PECOS PAC ID: 5991101297 Enrollment ID: I20210913001813 |
| Provider Name | Ashlie M Losee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760115505 PECOS PAC ID: 1355780156 Enrollment ID: I20240412001563 |
Bmh Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3456 E 17th St Ste 125, Ammon, ID 83406 Phone: 208-529-2828 | |
William Eder Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3040 E 17th St Ste A, Ammon, ID 83406 Phone: 208-557-0998 | |
Broulim Supermarkets, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2730 E Sunnyside Rd, Ammon, ID 83406 Phone: 208-522-3257 Fax: 208-522-3227 | |
Milestone Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1499 Curlew Dr, Ammon, ID 83406 Phone: 208-529-3342 Fax: 208-529-6631 | |
Fortify Optimal Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1189 Red Robin Ave, Ammon, ID 83401 Phone: 619-602-4520 | |
Root Cause Integrative Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1547 S Midway Ave, Suite B, Ammon, ID 83406 Phone: 208-497-0429 Fax: 208-497-0430 | |
Bore Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1498 Midway Ave Ste 2, Ammon, ID 83406 Phone: 208-529-9930 |