Active NPI
Gritman Medical Center Inc
- Psychiatry Physician
- Moscow, ID
National Provider Identifier
1235626474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 39
- Legal business name
- GRITMAN MEDICAL CENTER INC
- Practice address
- 803 S Main St Ste 210
Moscow, ID 83843-2695 - Phone
- (208) 883-6774
- Fax
- (208) 883-1398
- NPI assigned
- Apr 13, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Teresa Thorston
- Title
- PFS Super Visor
- Phone
- (208) 885-4511
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 39 | ID | Primary |
Addresses
Primary practice location
803 S Main St Ste 210
Moscow, ID 83843-2695
Mailing address
PO Box 8007
Moscow, ID 83843-0507
Phone (208) 882-4511
Other names 1
- Gritman Psychiatric Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Other NPIs on the same Medicare enrollment 8
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Interventional Pain Medicine Physician
- Moscow, ID
- NPI 1013556596
O20161130002249
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Moscow, ID
- NPI 1255496493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1235626474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8007",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838430507",
"telephone_number": "208-882-4511",
"fax_number": "208-883-6580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 S MAIN ST STE 210",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838432695",
"telephone_number": "208-883-6774",
"fax_number": "208-883-1398"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRITMAN MEDICAL CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-04-13",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "THORSTON",
"authorized_official_first_name": "TERESA",
"authorized_official_title_or_position": "PFS SUPER VISOR",
"authorized_official_telephone_number": "208-885-4511",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Gritman Psychiatric Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Gritman Psychiatric Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.