Salmon River Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

NP1202A Issued in ID

Legal business name

SALMON RIVER CLINIC

Practice address

403 Riverfront Dr
Salmon, ID 83467-5162

Phone

(208) 742-1110

Fax

(208) 742-1120

NPI assigned

Apr 28, 2017

Organization subpart

No

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

Authorized official

Name

Darci Neyman

Title

Office Manager

Phone

(208) 490-3118

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15946/brand/1/csg/1/fhir/r4

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennie Brumfield, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pocatello, ID
  • NPI 1811369689
  Medicare reassignment Care Compare group
• John Dustin Pena, FNP

  • Family Nurse Practitioner
  • Salmon, ID
  • NPI 1730787482
  Medicare reassignment Care Compare group
• Myllissa M. Wyatt, NP

  • Family Nurse Practitioner
  • Salmon, ID
  • NPI 1730439266
  Medicare reassignment Care Compare group
• Monica Lena White, NP

  • Family Nurse Practitioner
  • Salmon, ID
  • NPI 1548772338
  Medicare reassignment
• Katie S Hays, LCSW

  • Social Worker
  • Shoshone, ID
  • NPI 1235850538
  NPD

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1104351972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 RIVERFRONT DR",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834675162",
            "telephone_number": "208-742-1110",
            "fax_number": "208-742-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 RIVERFRONT DR",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834675162",
            "telephone_number": "208-742-1110",
            "fax_number": "208-742-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALMON RIVER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "NEYMAN",
        "authorized_official_first_name": "DARCI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-490-3118"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ID",
            "license": "NP1202A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Rogers, DDS
• Chloe Ann Russell-Evans, LMSW
• Salmon Mental Health Clinic PA
• Salmon Pharmacy, LLC
• Salmon River Chiropractic Inc.
• Salmon River Joint School District #243
• Salmon River Vision Clinic, PLLC
• Salmon Speech and Swallowing Service
• Salmon Valley Home Health LLC
• Saveway Market Inc

• Primary Care Clinic/Center in Salmon, ID
• Providers in Salmon, ID by specialty
• Primary Care Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.