NPIMap

Organization Active NPI

Eastern Idaho Public Health

  • Public Health or Welfare Agency
  • Idaho Falls, ID
National Provider Identifier
1205036001
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
EASTERN IDAHO PUBLIC HEALTH
Doing business as
Eastern Idaho Public Health
Practice address
1250 Hollipark Dr
Idaho Falls, ID 83401-6217
Phone
(208) 522-0310
Fax
(208) 525-7063
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Mr. William J Corbett
Title
Director
Phone
(208) 522-0310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1250 Hollipark Dr
Idaho Falls, ID 83401-6217

Mailing address

254 E St
Idaho Falls, ID 83402-3527
Phone (208) 522-0310

Other identifiers 1

IdentifierTypeStateIssuer
8077552MedicaidID

Other names 1

  • Eastern Idaho Public Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastern Idaho Public Health District6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1205036001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 E ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023527",
            "telephone_number": "208-522-0310",
            "fax_number": "208-525-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HOLLIPARK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016217",
            "telephone_number": "208-522-0310",
            "fax_number": "208-525-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IDAHO PUBLIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-522-0310",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8077552",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Idaho Public Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastern Idaho Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.