NPIMap

Individual provider Active NPI

David Teeples, D.O.

  • Family Medicine Physician
  • Malad, ID
National Provider Identifier
1003179706
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-0863 Issued in ID
Practice address
220 Bannock Street
Malad, ID 83252
Phone
(208) 766-2600
Fax
(208) 766-4258
NPI assigned
Jun 19, 2012
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-0863 ID Primary

Addresses

Primary practice location

220 Bannock Street
Malad, ID 83252

Mailing address

220 Bannock Street
Malad, ID 83252
Phone (208) 766-2600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehr-direct@oneidacountyclinic.hin.us Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150901001935 ID Practitioner - Family Practice 2264663178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Oneida County HospitalGroup PAC ID 3476459108, shared by 5 NPIs, 10 clinicians

Practice addresses (Care Compare)

220 Bannock St
Malad City, ID 83252-5068
Phone (208) 766-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O-0863IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oneida County Hospital Current Accepting new patients
Oneida County Hospital CurrentSince Jul 7, 2015 Accepting new patients
Oneida County Hospital Current Accepting new patients
Oneida County Hospital CurrentSince Jul 7, 2015 Accepting new patients

Locations

150 N 200 W
Malad City, ID 83252
Phone (208) 766-2231

220 Bannock St
Malad City, ID 83252
Phone (208) 766-2231

Interoperability endpoints

  • Direct secure messaging: ehr-direct@oneidacountyclinic.hin.us

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1003179706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BANNOCK STREET",
            "city": "MALAD",
            "state": "ID",
            "postal_code": "83252",
            "telephone_number": "208-766-2600",
            "fax_number": "208-766-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BANNOCK STREET",
            "city": "MALAD",
            "state": "ID",
            "postal_code": "83252",
            "telephone_number": "208-766-2600",
            "fax_number": "208-766-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEPLES",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-0863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehr-direct@oneidacountyclinic.hin.us",
            "affiliation": "N",
            "endpointDescription": "Oneida County Clinic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "220 Bannock Street",
            "city": "Malad",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Malad, ID

Sources for this page

Verify at the official NPI Registry.