Pocatello Health Services, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

12 Issued in ID

Legal business name

POCATELLO HEALTH SERVICES, LLC

Doing business as

Portneuf Medical Practices

Practice address

777 Hospital Way
Pocatello, ID 83201-5175

Phone

(208) 239-2065

Fax

(208) 239-3754

NPI assigned

Jun 26, 2009

Last updated

Apr 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John E Abreu

Title

Cfo

Phone

(208) 239-1020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Portneuf Medical Practices Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852

  O20090701000646

  Same enrollment

Locations

Practitioners 243

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mara Additon, M.D.

  • Surgery Physician
  • Pocatello, ID
  • NPI 1184067613
  NPD
• Bruce J Andersen, MD

  • Neurological Surgery Physician
  • Boise, ID
  • NPI 1063420792
  NPD
• Douglas Ken Andersen, DO

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1730599598
  NPD
• Gabriela Anghel, MD

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1598196784
  NPD
• Kealee Arehart, NP

  • Family Nurse Practitioner
  • Pocatello, ID
  • NPI 1043968290
  NPD
• Chelsey Aslett, NP-C

  • Family Nurse Practitioner
  • Pocatello, ID
  • NPI 1124851357
  NPD
• Jordan Lyle Bailey, M.D.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1225124936
  NPD
• Harriet Barratt, M.D.

  • Trauma Surgery Physician
  • Pocatello, ID
  • NPI 1326539685
  NPD
• Cynthia Love Barron, CNS

  • Adult Health Clinical Nurse Specialist
  • Pocatello, ID
  • NPI 1902039951
  NPD
• Christian Beauregard, DO

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1952984973
  NPD
• Umesh Chander Bhandari, M.D.

  • Psychiatry Physician
  • Twin Falls, ID
  • NPI 1548572274
  NPD
• Ryan Andrew Billington, M.D.

  • Psychiatry Physician
  • Nampa, ID
  • NPI 1891182861
  NPD

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1215165485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4168",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054168",
            "telephone_number": "208-239-2065",
            "fax_number": "208-239-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-2065",
            "fax_number": "208-239-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCATELLO HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-26",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "ABREU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-239-1020"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ID",
            "license": "12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808437000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portneuf Medical Practices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pocatello Free Clinic
• Pocatello Health Services, Inc. (Gateway Transitional Care Center)
• Pocatello Health Services, Inc. (Gateway Transitional Care Center)
• Pocatello Health Services, LLC (Portneuf Contracted Physicians)
• Pocatello Health Services, LLC
• Pocatello Health Services, LLC
• Pocatello Health Services, LLC
• Pocatello Health Services, LLC
• Pocatello Hospital LLC (Portneuf Rehabilitation Center)
• Pocatello Hospital LLC (Portneuf Medical Center)

• General Acute Care Hospital in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Acute Care Hospital in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.