NPIMap

Individual provider Active NPI

Shawn D Speirs, D.O.

  • Hospitalist Physician
  • Idaho Falls, ID
National Provider Identifier
1104976653
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
O254 Issued in ID
Practice address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone
(208) 227-2575
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X O254 ID
Hospitalist Physician 208M00000X O254 ID Primary

Addresses

Primary practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

2860 Channing Way Ste 213
Idaho Falls, ID 83404-7541
Phone (208) 227-2570

Other identifiers 1

IdentifierTypeStateIssuer
806046300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000922 ID Practitioner - Internal Medicine 0042272031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Snake River Hospitalists LLCGroup PAC ID 7113359969, 9 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O254IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Snake River Hospitalists, LLC Hospitalist CurrentSince Nov 1, 2019 Accepting new patients
Utah Regional Hospitalists LLC Hospitalist CurrentSince Jun 2, 2019 Accepting new patients
Idaho Falls Community Hospital LLC Past Accepting new patients

Locations

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aspen Home Health and HospiceIdaho Falls, ID, CCN 131541 Hospice Contracted Managing Employee Apr 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1104976653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY STE 213",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047541",
            "telephone_number": "208-227-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-227-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIRS",
        "first_name": "SHAWN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "O254",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "O254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806046300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.