Teton Radiology Diagnostic, LLC

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

TETON RADIOLOGY DIAGNOSTIC, LLC

Practice address

2001 S Woodruff Ave Ste 17
Idaho Falls, ID 83404-6372

Phone

(208) 524-7237

NPI assigned

Apr 27, 2009

Organization subpart

Yes

Parent organization

TETON RADIOLOGY DIAGNOSITC, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Michael P Hodel

Title

General Manager

Phone

(208) 542-5000

Specialties & licenses 1

Addresses

Part of

Teton Radiology Diagnostic

Practitioners 2

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

• Peter L Vance, MD

  • Diagnostic Radiology Physician
  • Idaho Falls, ID
  • NPI 1619056199
  NPD
• Jared Bailey, M.D.

  • Vascular & Interventional Radiology Physician
  • Pocatello, ID
  • NPI 1891929519
  NPD (past)

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1194969725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30015",
            "address_2": "DEPT 594",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300015",
            "telephone_number": "800-475-6236",
            "fax_number": "706-596-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 17",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046372",
            "telephone_number": "208-524-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON RADIOLOGY DIAGNOSTIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETON RADIOLOGY DIAGNOSITC, LLC",
        "enumeration_date": "2009-04-27",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "HODEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "208-542-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teton Oms
• Teton Outpatient, LLC
• Teton Physical Therapy, Inc
• Teton Plastic Surgery
• Teton Radiology Diagnostic a Series of Teton Group Enterprise
• Teton Surgical Specialties PLLC
• Teton Women'S Health Center
• Alisha Michelle Tew, CMA, CNA, PA
• Dustin Ferrel Tew, D.O.
• Joshua Gerald Tew, PA-C

• Body Imaging Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Body Imaging Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.