Teton Open MRI of Pocatello, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

TETON OPEN MRI OF POCATELLO, LLC

Practice address

246 N 18TH Ave
Pocatello, ID 83201-3356

Phone

(208) 552-0828

Fax

(208) 552-0829

NPI assigned

Feb 8, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Bonnie C Gray

Title

Administrative Assistant

Phone

(208) 552-0828

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Glenn P Moradian, MD

  • Diagnostic Radiology Physician
  • Williston, ND
  • NPI 1356349955
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194798397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 N 18TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013356",
            "telephone_number": "208-552-0828",
            "fax_number": "208-552-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 N 18TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013356",
            "telephone_number": "208-552-0828",
            "fax_number": "208-552-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON OPEN MRI OF POCATELLO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "208-552-0828",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tensel LLC
• Tensel LLC-TCM
• Cheri Elizabeth Tensel
• William Jared Terry, DMD
• Teton Family Services, Inc.
• Teton Spine PLLC
• Teton Spine, PLLC
• Teton Vascular Institute of Pocatello a Series of Teton Group
• Andrew Thayne, M.D.
• The Academy at Roosevelt Center

• Radiology Clinic/Center in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Radiology Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.