Teton MRI of Idaho Falls

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

TETON MRI OF IDAHO FALLS

Practice address

2060 S Woodruff Ave
Idaho Falls, ID 83404-6396

Phone

(208) 552-0828

Fax

(208) 552-0829

NPI assigned

Sep 6, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Bonnie C. Gray

Title

Administrative Assistant

Phone

(208) 552-0828

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1053305144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046396",
            "telephone_number": "208-552-0828",
            "fax_number": "208-552-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046396",
            "telephone_number": "208-552-0828",
            "fax_number": "208-552-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON MRI OF IDAHO FALLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "208-552-0828",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teton Foot & Ankle Center, PC
• Teton Home Health, LLC (Avalon Home Health, LLC)
• Teton Hospice
• Teton Hospitalist Services, PLLC
• Teton Microbiology Laboratory
• Teton Nuclear Medicine Service LLC
• Teton Obstetrics and Gynecology PA
• Teton Oms (Snake River Surgical)
• Teton Outpatient, LLC
• Teton Physical Therapy, Inc

• Radiology Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Radiology Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.