NPIMap

Organization Active NPI

Idaho Dept. of Health & Welfare

  • Community/Behavioral Health Agency
  • Burley, ID
National Provider Identifier
1033240296
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IDAHO DEPT. OF HEALTH & WELFARE
Practice address
2241 Overland Ave.
Burley, ID 83318-2929
Phone
(208) 677-5390
Fax
(208) 677-4002
NPI assigned
Mar 8, 2007
Last updated
Jan 9, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
IDAHO DEPT. OF HEALTH & WELFAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
Scott Rasmussen, LCSW
Title
Human Services Field Program Manage
Phone
(208) 732-1601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2241 Overland Ave.
Burley, ID 83318-2929

Mailing address

2241 Overland Ave.
Burley, ID 83318-2929
Phone (208) 677-5390

Other identifiers 3

IdentifierTypeStateIssuer
000010025421OtherIDBLUE SHIELD
8073513MedicaidID
HW173OtherIDBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
State of Idaho Dept Health114 organizations share this tax ID, including this one
Part of
State of Idaho Dept Health

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

2241 Overland Ave
Burley, ID 83318
Phone (208) 312-5407

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1033240296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 OVERLAND AVE.",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182929",
            "telephone_number": "208-677-5390",
            "fax_number": "208-677-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 OVERLAND AVE.",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182929",
            "telephone_number": "208-677-5390",
            "fax_number": "208-677-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT. OF HEALTH & WELFARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDAHO DEPT. OF HEALTH & WELFARE",
        "enumeration_date": "2007-03-08",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "RASMUSSEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "HUMAN SERVICES FIELD PROGRAM MANAGE",
        "authorized_official_telephone_number": "208-732-1601",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010025421",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8073513",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HW173",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.