NPIMap

Organization Active NPI

Michael K Taylor, MD, & Jason T Halverson, MD, PLLC

  • Ophthalmology Physician
  • Twin Falls, ID
National Provider Identifier
1164455259
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MICHAEL K TAYLOR, MD, & JASON T HALVERSON, MD, PLLC
Practice address
261 Canyon Crest Dr Ste 100
Twin Falls, ID 83301-5924
Phone
(208) 733-5300
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Dr. Jason T Halverson, MDNPI 1619921236
Title
Owner
Phone
(208) 733-5300

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

261 Canyon Crest Dr Ste 100
Twin Falls, ID 83301-5924

Mailing address

261 Canyon Crest Dr Ste 100
Twin Falls, ID 83301-5924
Phone (208) 733-5300

Other identifiers 1

IdentifierTypeStateIssuer
805175600MedicaidID

Other names 1

  • Canyon Crest Eye Phys Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Direct@TaylorHalversonOphthalmoloTwinFallsID.CompulinkDirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060405000464 ID Part B Supplier - Clinic/Group Practice 1658389432 Receives reassigned benefits from 3 practitioners
Practice locations: Burley, ID; Twin Falls, ID

National Provider Directory

National Provider Directory

Locations

1252 Bennett Ave
#A
Burley, ID 83318
Phone (208) 678-0573

261 Canyon Crest Dr
#100
Twin Falls, ID 83301
Phone (208) 733-5300

206 Martin St
#A
Twin Falls, ID 83301
Phone (208) 733-5300

Practitioners & affiliated clinicians

Practitioners 9

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1164455259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 CANYON CREST DR STE 100",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015924",
            "telephone_number": "208-733-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 CANYON CREST DR STE 100",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015924",
            "telephone_number": "208-733-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL K TAYLOR, MD, & JASON T HALVERSON, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "HALVERSON",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-733-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805175600",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Direct@TaylorHalversonOphthalmoloTwinFallsID.CompulinkDirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "261 Canyon Crest Dr",
            "city": "Twin Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "833015359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Canyon Crest Eye Phys",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.