| Rocky Mountain Diabetes And Osteoporosis Center Pa | |
|
3910 Washington Pkwy Idaho Falls ID 83404-7596 | |
| (208) 522-2996 | |
| (208) 523-3318 |
| Full Name | Rocky Mountain Diabetes And Osteoporosis Center Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3910 Washington Pkwy, Idaho Falls, Idaho |
| Authorized Official Name and Position | Janet M Hoover (BILLING LEAD) |
| Authorized Official Contact | 2085222996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Diabetes And Osteoporosis Center Pa 3910 Washington Pkwy Idaho Falls ID 83404-7596 Ph: (208) 522-2996 | Rocky Mountain Diabetes And Osteoporosis Center Pa 3910 Washington Pkwy Idaho Falls ID 83404-7596 Ph: (208) 522-2996 |
| NPI Number | 1336220243 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 07/27/2009 |
| Medicare PECOS PAC ID | 5890750483 |
|---|---|
| Medicare Enrollment ID | O20041123000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336220243 | NPI | - | NPPES |
| 42200 | Other | BLUE CROSS | |
| 804012300 | Other | HEALTHY CONNECTIONS |
| Provider Name | David R Liljenquist |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1932109931 PECOS PAC ID: 4587695218 Enrollment ID: I20050823000476 |
| Provider Name | Brittany J Mcintosh |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1518075670 PECOS PAC ID: 9537261896 Enrollment ID: I20070216000684 |
| Provider Name | Kesta L Taylor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649388703 PECOS PAC ID: 0941389977 Enrollment ID: I20080502000050 |
| Provider Name | Jonathan K Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821253683 PECOS PAC ID: 0547328494 Enrollment ID: I20081021000520 |
| Provider Name | John E Liljenquist |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1619977600 PECOS PAC ID: 3870558463 Enrollment ID: I20100120000865 |
| Provider Name | Carl D Vance |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1437159423 PECOS PAC ID: 9133216369 Enrollment ID: I20100604000314 |
| Provider Name | Rebecca Tufts Sulik |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1013940386 PECOS PAC ID: 7315113651 Enrollment ID: I20120109000132 |
| Provider Name | Barbara Jean Moulton |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275552978 PECOS PAC ID: 5496921777 Enrollment ID: I20120109000544 |
| Provider Name | Adam C Matthews |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134411408 PECOS PAC ID: 0446400261 Enrollment ID: I20121031000689 |
| Provider Name | Lisa Ann Hardy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679813489 PECOS PAC ID: 3375783145 Enrollment ID: I20130628000475 |
| Provider Name | Beatriz Diaz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437531738 PECOS PAC ID: 3274846415 Enrollment ID: I20150717000712 |
| Provider Name | Susannah Hancock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164973053 PECOS PAC ID: 1658652318 Enrollment ID: I20170111003078 |
| Provider Name | Kathryn E Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619416674 PECOS PAC ID: 5890062699 Enrollment ID: I20170526001920 |
| Provider Name | Joshua M Smith |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154528727 PECOS PAC ID: 5193856193 Enrollment ID: I20171027002249 |
| Provider Name | Jacqlyn A Raivo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740746403 PECOS PAC ID: 4880935550 Enrollment ID: I20190405000790 |
| Provider Name | Ivon Carrillo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821656356 PECOS PAC ID: 0648508887 Enrollment ID: I20190826001868 |
| Provider Name | Sara J Brown |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932773413 PECOS PAC ID: 8123428745 Enrollment ID: I20210617002557 |
| Provider Name | Kevin T Prier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801393798 PECOS PAC ID: 3577944040 Enrollment ID: I20220714001595 |
| Provider Name | Jedd Douglas Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326751132 PECOS PAC ID: 9335511336 Enrollment ID: I20230220001441 |
| Provider Name | Justin W Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003581620 PECOS PAC ID: 5597154625 Enrollment ID: I20230308001293 |
| Provider Name | Lynnette T Barker |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841905270 PECOS PAC ID: 9830564913 Enrollment ID: I20230403000692 |
Shane G Machen, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1995 E 17th St Ste A, Idaho Falls, ID 83404 Phone: 208-522-7666 Fax: 208-524-2821 | |
Physician Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 | |
Family First Medical Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3614 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-552-7700 Fax: 208-552-1783 | |
Imed Hrs Idaho Falls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 801-507-3500 | |
Neville Spinal Balance Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2145 West Broadway Street, Idaho Falls, ID 83402 Phone: 208-522-3130 | |
R.k. Arbon, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 Channing Way, Suite 116, Idaho Falls, ID 83404 Phone: 208-529-0575 Fax: 208-528-0223 | |
Idaho Falls Family & Sports Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404 Phone: 208-524-3416 Fax: 208-524-3138 |