Tina Guedes, NP
Individual provider Active NPI Family Nurse Practitioner · Lava Hot Springs, ID
NPI 1194366013 · NPPES record last updated Jan 17, 2024
Key facts
- NPI
- 1194366013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 60443 (ID)
- Practice address
- 85 S 5TH W
Lava Hot Springs, ID 83246 - Phone
- (208) 776-5202
- Fax
- (844) 492-9775
- NPI assigned
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health West Inc
Practice addresses (Care Compare)
655 S 4TH
Suite 600
Preston, ID 83263-1624
Phone 20823278621122
Hospital & facility affiliations
- Symbii Home Health
- Portneuf Medical Center
- Caribou Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200204002993 | ID | Practitioner - Nurse Practitioner | 2466888748 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60443 | ID | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health West, Inc. | Family Medicine | Current | Accepting new patients |
| Health West, Inc. | Family Medicine | Current | Accepting new patients |
| Health West, Inc. | Current |
Accepting new patients | |
| Health West, Inc. | Family Medicine | Current | Accepting new patients |
| Health West, Inc. | Current |
Accepting new patients | |
| Health West, Inc. | Current | Accepting new patients | |
| Health West, Inc. | Family Medicine | Past | Accepting new patients |
| Health West, Inc. | Family Medicine | Past | Accepting new patients |
| Health West, Inc. | Past | Accepting new patients | |
| Health West, Inc. | Family Medicine | Past | Accepting new patients |
| Health West, Inc. | Past | Accepting new patients | |
| Health West, Inc. | Family Medicine | Past | Accepting new patients |
Locations
823 Reed St
American Falls, ID 83211
Phone (208) 226-2822
152 S 4th St
Montpelier, ID 83254
Phone (208) 847-2108
500 S 11th Ave
Ste 400
Pocatello, ID 83201
465 Memorial Dr
Pocatello, ID 83201
Phone (208) 234-4700
880 W Quinn Rd
Pocatello, ID 83202
Phone (208) 238-2000
1000 N 8th Ave
Pocatello, ID 83201
Phone (208) 232-6260
1001 N 7th Ave
Ste 135
Pocatello, ID 83201
Phone (208) 234-2489
500 S 11th Ave
Ste 204
Pocatello, ID 83201
Phone (208) 232-1443
655 S 4th E
Ste 600
Preston, ID 83263
Phone 20823278621122
Interoperability endpoints
- tina.guedes.1@16258.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 60443 | ID | Yes |
Addresses
Primary practice location
85 S 5TH W
Lava Hot Springs, ID 83246
Mailing address
500 S 11TH Ave Ste 400
Pocatello, ID 83201-4880
Phone (208) 232-7862
Other providers in Lava Hot Springs, ID
- Helene P Edmo
- Pamela Goodliffe
- Health West, Inc.
- Robert Brent Hubbard
- Lava Hot Springs Academy
- Nursing U Home Transport LLC
- Road to Recovery, Inc.
All providers in Lava Hot Springs, ID · Family Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.