NPIMap

Organization Active NPI

Intermountain Esd

Doing business as Imesdreg

  • Local Education Agency (LEA)
  • Pendleton, OR
National Provider Identifier
1104916311
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
INTERMOUNTAIN ESD
Doing business as
Imesdreg
Practice address
2001 SW Nye Ave
Pendleton, OR 97801-4416
Phone
(541) 276-6616
Fax
(541) 276-4252
NPI assigned
Oct 16, 2006
Last updated
Jun 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Dr. Mark S. Mulvihill
Title
Superintendent
Phone
(541) 966-3101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

2001 SW Nye Ave
Pendleton, OR 97801-4416

Mailing address

2001 SW Nye Ave
Pendleton, OR 97801-4416
Phone (541) 276-6616

Other identifiers 1

IdentifierTypeStateIssuer
276309MedicaidOR

Other names 1

  • IMESDREG Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imesd4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1104916311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SW NYE AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014416",
            "telephone_number": "541-276-6616",
            "fax_number": "541-276-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SW NYE AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014416",
            "telephone_number": "541-276-6616",
            "fax_number": "541-276-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN ESD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "MULVIHILL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "541-966-3101",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276309",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMESDREG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.