MV Pocatello ENT, LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

MV POCATELLO ENT, LLC

Practice address

333 N 18TH Ave Ste B3
Pocatello, ID 83201

Phone

(208) 232-2146

NPI assigned

Aug 15, 2018

Organization subpart

No

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

Authorized official

Name

Ned Hillyard, CCO

Title

Chief Compliance Officer

Phone

(208) 709-4571

Specialties & licenses 1

Addresses

Other names 1

• MVH Gastroenterology LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mountain View Hospital LLC

  • Customized Equipment (DME)
  • Idaho Falls, ID
  • NPI 1730423492

  Member Of

  NPD member

Locations

Practitioners 8

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

• David R Donaldson, MD

  • Otolaryngology Physician
  • Pocatello, ID
  • NPI 1114914512

  ID, Otolaryngology

  Medicare reassignment Care Compare group NPD
• Kraig C McGee, MD

  • Otolaryngology Physician
  • Pocatello, ID
  • NPI 1821083544

  ID, Otolaryngology

  Medicare reassignment Care Compare group NPD
• Jeff E Brockett, ED.D

  • Audiologist
  • Pocatello, ID
  • NPI 1013931450

  ID

  Medicare reassignment NPD
• Scott Ryan Hall, M.D.

  • Otolaryngology Physician
  • Idaho Falls, ID
  • NPI 1811343692

  ID, Otolaryngology

  Medicare reassignment NPD
• Chris A. Sanford, PHD

  • Audiologist
  • Pocatello, ID
  • NPI 1699869354

  ID

  Medicare reassignment NPD
• Kimberly Jean Thomas, FNP-C

  • Family Nurse Practitioner
  • Pocatello, ID
  • NPI 1265155204

  ID

  Medicare reassignment NPD
• Jessica Bailey, PA

  • Surgical Physician Assistant
  • Pocatello, ID
  • NPI 1588909261

  ID

  Medicare reassignment
• Alan K Mirly, PA

  • Physician Assistant
  • Vancouver, WA
  • NPI 1891780524
  NPD (past)

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1154801595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N 18TH AVE STE B3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013358",
            "telephone_number": "208-232-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 18TH AVE STE B3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MV POCATELLO ENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "HILLYARD",
        "authorized_official_first_name": "NED",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "208-709-4571",
        "authorized_official_credential": "CCO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MVH Gastroenterology LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Matthew Ayers Murdoch, M.D.
• Nicole Murdock, PHARMD
• Roger Franklin Murphy, PHARMD
• Virginia Ann Murphy, NP
• Morgan Elizabeth Murray
• MVH Endoscopy LLC
• MVH PC Specialists LLC
• MVH Pic LLC
• MVH PMHS LLC
• MVH Surgical Specialists LLC

• All providers in Pocatello, ID
• Otolaryngology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.