| Adams County Health Center Inc | |
|
205 N Berkley Council ID 83612-0428 | |
| (208) 253-4242 | |
| (208) 253-6849 |
| Full Name | Adams County Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 N Berkley, Council, Idaho |
| Authorized Official Name and Position | Denise A Langston-groves (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2082534242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adams County Health Center Inc Po Box 428 Council ID 83612-0428 Ph: (208) 253-4242 | Adams County Health Center Inc 205 N Berkley Council ID 83612-0428 Ph: (208) 253-4242 |
| NPI Number | 1710915897 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 03/11/2016 |
| Medicare PECOS PAC ID | 1557453446 |
|---|---|
| Medicare Enrollment ID | O20070823000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710915897 | NPI | - | NPPES |
| 1700100 | Other | ID | CIGNA |
| 1700101 | Other | ID | CIGNA |
| 807150400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | San Juanita Aguilar |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881930378 PECOS PAC ID: 7618955543 Enrollment ID: I20040708000740 |
| Provider Name | Susan M Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942359898 PECOS PAC ID: 2567539281 Enrollment ID: I20080927000108 |
| Provider Name | Jean P Cole |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871768119 PECOS PAC ID: 9537230040 Enrollment ID: I20100813000594 |
| Provider Name | Kevin B Mcsweeney |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841397940 PECOS PAC ID: 3870719685 Enrollment ID: I20140730001811 |
| Provider Name | Jordan V Blanchard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356630941 PECOS PAC ID: 2365691870 Enrollment ID: I20141103002412 |
| Provider Name | Tyler E Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174936462 PECOS PAC ID: 2769600022 Enrollment ID: I20150528001441 |
| Provider Name | Elizabeth L Bauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255721361 PECOS PAC ID: 6709185572 Enrollment ID: I20160428001529 |
| Provider Name | Tawni L Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508226226 PECOS PAC ID: 9335421114 Enrollment ID: I20170131002781 |
| Provider Name | Heather M Bergstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942626171 PECOS PAC ID: 7517180326 Enrollment ID: I20171113002570 |
| Provider Name | Amy Louise Beam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528550860 PECOS PAC ID: 8224377049 Enrollment ID: I20190221003196 |
| Provider Name | Scott A Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760950604 PECOS PAC ID: 5698017762 Enrollment ID: I20190422001834 |
| Provider Name | Stephen J Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083014997 PECOS PAC ID: 3274895164 Enrollment ID: I20200812001087 |
| Provider Name | Faith A Bohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184334443 PECOS PAC ID: 2668845066 Enrollment ID: I20230306002484 |
Payette Lakes Medical Clinic, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Council Avenue, Suite C, Council, ID 83612 Phone: 208-253-4915 Fax: 208-253-4917 |