Idaho Falls ASC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

IDAHO FALLS ASC

Practice address

3302 Valencia Drive
Suite 101a
Idaho Falls, ID 83404

Phone

(208) 557-4525

Fax

(208) 542-4280

NPI assigned

Sep 5, 2018

Organization subpart

No

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

Authorized official

Name

Ned W Hillyard

Title

Cco

Phone

(208) 557-2711

Specialties & licenses 1

Addresses

Listed as

Eagle Rock Ambulatory Surgery CenterCCN 13C0001083

Medicare certification status

Terminated Voluntary: merger or closure, Apr 2, 2026From the Provider of Services file

Locations

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1174005235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 VALENCIA DR STE 101A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047068",
            "telephone_number": "208-557-4525",
            "fax_number": "208-542-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 VALENCIA DRIVE",
            "address_2": "SUITE 101A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-557-4525",
            "fax_number": "208-542-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO FALLS ASC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "HILLYARD",
        "authorized_official_first_name": "NED",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "208-557-2711"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Direct Physical Therapy, PLLC
• Idaho Eye Center PA
• Idaho Eye Center PA
• Idaho Eye Pros Idaho Falls LLC
• Idaho Falls Arthritis Clinic PC
• Idaho Falls Clinic, P.a.
• Idaho Falls Community Hospital LLC
• Idaho Falls Dental Group
• Idaho Falls Dermatology P a
• Idaho Falls Family YMCA

• Ambulatory Surgical Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.