NPIMap

Organization Active NPI

Canvi Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chubbuck, ID
National Provider Identifier
1144984873
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CANVI BEHAVIORAL HEALTH PLLC
Practice address
4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone
(208) 252-5621
Fax
(208) 648-4167
NPI assigned
Oct 28, 2021
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Krista BattsNPI 1083560460
Title
Contracting Manager
Phone
(208) 380-4978

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Mailing address

PO Box 2516
Pocatello, ID 83206-2516
Phone (208) 380-4978

Other practice location 1

347 W Gordon Ave Ste 1
Layton, UT 84041-2389
Phone (801) 896-5341

Other practice location 2

333 W Cedar St Ste 3
Pocatello, ID 83201-5045
Phone (208) 252-5621

Other practice location 3

476 Heritage Park Blvd Ste 230
Layton, UT 84041-5636
Phone (801) 896-5345

Other practice location 4

1120 Stocks Ave Ste 102
Rexburg, ID 83440-3508
Phone (208) 745-2580

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL kbatts@canvihealth.com Direct
CONNECT URL kbatts@canvihealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220121000627 ID Part B Supplier - Clinic/Group Practice 0941692073 Receives reassigned benefits from 15 practitioners
Practice locations: Mt Home, ID; Nampa, ID; Pocatello, ID; Rexburg, ID; Saint Anthony, ID; Salmon, ID; Shoshone, ID; Twin Falls, ID…
O20220614002943 UT Part B Supplier - Clinic/Group Practice 0941692073 Receives reassigned benefits from 7 practitioners
Practice locations: Farr West, UT; Layton, UT; Ogden, UT; Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

495 Emerald Ave
Blackfoot, ID 83221
Phone (208) 932-4545

4615 S Locust Grove Rd
Meridian, ID 83642

1120 Stocks Ave
Ste 102
Rexburg, ID 83440
Phone (208) 745-2580

1120 Stocks Ave
Ste B
Rexburg, ID 83440

610 N Bridge St
Saint Anthony, ID 83445
Phone (208) 380-4978

600 Shanafelt St
Salmon, ID 83467
Phone (208) 756-8391

476 Heritage Park Blvd
Ste 230
Layton, UT 84041
Phone (801) 896-5345

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1144984873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2516",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062516",
            "telephone_number": "208-380-4978",
            "fax_number": "208-648-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 W Gordon Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840412389",
            "country_code": "US",
            "telephone_number": "801-896-5341",
            "fax_number": "801-896-5334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 W Cedar St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832015045",
            "country_code": "US",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "476 Heritage Park Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840415636",
            "country_code": "US",
            "telephone_number": "801-896-5345",
            "fax_number": "801-896-5334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 Stocks Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834403508",
            "country_code": "US",
            "telephone_number": "208-745-2580",
            "fax_number": "208-648-4167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANVI BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "BATTS",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "CONTRACTING MANAGER",
        "authorized_official_telephone_number": "208-380-4978"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kbatts@canvihealth.com",
            "affiliation": "N",
            "endpointDescription": "Canvi Behavior Health PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "333 W Cedar St Ste 3",
            "city": "Pocatello",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832015045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kbatts@canvihealth.com",
            "affiliation": "N",
            "endpointDescription": "CAnvi Behavioral Health PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4650 Hawthorne Rd Ste 3B",
            "city": "Chubbuck",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832022376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.