NPIMap

Organization Active NPI

Rocky Mountain Womens Clinic LLC

  • Midwife
  • Idaho Falls, ID
National Provider Identifier
1104436195
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Legal business name
ROCKY MOUNTAIN WOMENS CLINIC LLC
Practice address
2065 E 17TH St Ste a
Idaho Falls, ID 83404-8042
Phone
(208) 497-0541
Fax
(208) 497-0873
NPI assigned
Aug 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Kylee Johnson, CNMNPI 1538636121
Title
Owner
Phone
(208) 497-0541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 176B00000X Primary
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X

Addresses

Primary practice location

2065 E 17TH St Ste a
Idaho Falls, ID 83404-8042

Mailing address

PO Box 2578
Idaho Falls, ID 83403-2578
Phone (208) 497-0541

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1104436195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2578",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032578",
            "telephone_number": "208-497-0541",
            "fax_number": "208-497-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 E 17TH ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048042",
            "telephone_number": "208-497-0541",
            "fax_number": "208-497-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN WOMENS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KYLEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-497-0541",
        "authorized_official_credential": "CNM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.