| Genesis Restorative Medicine | |
|
496 Shoup Ave W Ste B Twin Falls ID 83301-5043 | |
| (208) 739-9961 | |
| (208) 739-9962 |
| Full Name | Genesis Restorative Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 496 Shoup Ave W Ste B, Twin Falls, Idaho |
| Authorized Official Name and Position | Lindsay Hubsmith (OWNER) |
| Authorized Official Contact | 2083583225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Restorative Medicine 496 Shoup Ave W Ste B Twin Falls ID 83301-5043 Ph: (208) 739-9961 | Genesis Restorative Medicine 496 Shoup Ave W Ste B Twin Falls ID 83301-5043 Ph: (208) 739-9961 |
| NPI Number | 1487393393 |
|---|---|
| Provider Enumeration Date | 05/31/2022 |
| Last Update Date | 01/27/2023 |
| Medicare PECOS PAC ID | 2365823069 |
|---|---|
| Medicare Enrollment ID | O20220712003605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487393393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Lauren A Schoessler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720559404 PECOS PAC ID: 0042558470 Enrollment ID: I20190211001638 |
| Provider Name | Jessica Torrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205307097 PECOS PAC ID: 1052644044 Enrollment ID: I20190606000353 |
| Provider Name | Bryan L Gourley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629500947 PECOS PAC ID: 8921346727 Enrollment ID: I20190625001960 |
| Provider Name | Kristy Handyside |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437715208 PECOS PAC ID: 5294066254 Enrollment ID: I20191007001714 |
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