NPIMap

Organization Active NPI

Gritman Medical Center Inc

Doing business as Gritman Psychiatric Services

  • Psychiatry Physician
  • Moscow, ID
National Provider Identifier
1235626474
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
39 Issued in ID
Legal business name
GRITMAN MEDICAL CENTER INC
Doing business as
Gritman Psychiatric Services
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
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161130002249 ID Part B Supplier - Clinic/Group Practice 4981984390 Receives reassigned benefits from 29 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Moscow, ID

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

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.

Verify at the official NPI Registry.