NPIMap

Organization Active NPI

Health Atlast Pocatello LLC

  • Physical Medicine & Rehabilitation Physician
  • Pocatello, ID
National Provider Identifier
1235789249
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
HEALTH ATLAST POCATELLO LLC
Practice address
1800 Flandro Dr Ste 110
Pocatello, ID 83202-4936
Phone
(208) 242-3723
Fax
(208) 904-1052
NPI assigned
Sep 12, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Dr. Shaloam Agalelei Ofisa, D.C., M.S.NPI 1952713166
Title
Owner
Phone
(208) 242-3723

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Acupuncturist 171100000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary
General Practice Physician 208D00000X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

1800 Flandro Dr Ste 110
Pocatello, ID 83202-4936

Mailing address

1800 Flandro Dr Ste 110
Pocatello, ID 83202-4936
Phone (208) 242-3723

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1235789249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR STE 110",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024936",
            "telephone_number": "208-242-3723",
            "fax_number": "208-904-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR STE 110",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024936",
            "telephone_number": "208-242-3723",
            "fax_number": "208-904-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH ATLAST POCATELLO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "OFISA",
        "authorized_official_first_name": "SHALOAM",
        "authorized_official_middle_name": "AGALELEI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-242-3723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., M.S."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.