Idaho Regional Hand & Upper Extremity Center PLLC

Primary specialty

Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X

License

O-0574 Issued in ID

Legal business name

IDAHO REGIONAL HAND & UPPER EXTREMITY CENTER PLLC

Practice address

444 Hospital Way Ste 710
Pocatello, ID 83201

Phone

(208) 235-4263

Fax

(208) 233-4268

NPI assigned

Mar 5, 2013

Last updated

Aug 30, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Dee Stucki, DONPI 1083857536

Title

President

Phone

(208) 235-4263

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Dee Stucki, DO

  • Orthopaedic Hand Surgery Physician
  • Pocatello, ID
  • NPI 1083857536
  Medicare reassignment Care Compare group Authorized official
• Ryan Ned Miller, D.O.

  • Orthopaedic Surgery Physician
  • Pocatello, ID
  • NPI 1073877213

  Hand Surgery

  Medicare reassignment Care Compare group NPD
• Dale McKay Belnap, PA-C

  • Surgical Physician Assistant
  • Pocatello, ID
  • NPI 1962832923
  Medicare reassignment Care Compare group
• Jason A Romriell, PA-C

  • Physician Assistant
  • Spokane, WA
  • NPI 1700855574

  ID

  Medicare reassignment Care Compare group
• Vermon S Esplin, MD

  • Surgery of the Hand (Surgery) Physician
  • Pocatello, ID
  • NPI 1457345316
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1003157801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 710",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012745",
            "telephone_number": "208-235-4263",
            "fax_number": "208-233-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 710",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-235-4263",
            "fax_number": "208-233-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO REGIONAL HAND & UPPER EXTREMITY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "STUCKI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-235-4263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-684",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "ID",
            "license": "M-8547",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "ID",
            "license": "O-0574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Idaho Sports & Spine PLLC
• Idaho State University
• Idaho State University
• Idaho State University (Idaho State University Physical and Occupational Therapy Associates)

• Orthopaedic Hand Surgery Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Orthopaedic Hand Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.