NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Itp Region 2

  • Early Intervention Provider Agency
  • Lewiston, ID
National Provider Identifier
1053450221
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE ITP REGION 2
Practice address
2604 16TH Ave
Lewiston, ID 83501-3539
Phone
(208) 799-3460
Fax
(208) 799-3466
NPI assigned
Feb 5, 2007
Last updated
Aug 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Ms. Mary J Jones, B.U.S.
Title
Program Manager
Phone
(208) 334-5523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X ID Primary
Local Education Agency (LEA) 251300000X NU

Addresses

Primary practice location

2604 16TH Ave
Lewiston, ID 83501-3539

Mailing address

1118 F St
PO Drawer B
Lewiston, ID 83501-1930
Phone (208) 799-3460

Other identifiers 3

IdentifierTypeStateIssuer
000010018383OtherIDBLUE SHIELD
0028421MedicaidID
HW132OtherIDBLUE CROSS OF IDAHO

National Provider Directory

National Provider Directory
Tax ID family
Idaho Dept of Health Welfare Reg II Amh Grangeville114 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1053450221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 F ST",
            "address_2": "PO DRAWER B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011930",
            "telephone_number": "208-799-3460",
            "fax_number": "208-799-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 16TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013539",
            "telephone_number": "208-799-3460",
            "fax_number": "208-799-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE ITP REGION 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-334-5523",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.U.S."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010018383",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028421",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "HW132",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.