Organization Active NPI

West Valley Medical Group Specialty Services LLC

  • Obesity Medicine (Obstetrics & Gynecology) Physician
  • Caldwell, ID
National Provider Identifier
1245659093
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VB0002X
Legal business name
WEST VALLEY MEDICAL GROUP SPECIALTY SERVICES LLC
Practice address
315 Elm Street
Ste 310
Caldwell, ID 83605
Phone
(208) 454-2035
Fax
(208) 454-1065
NPI assigned
Apr 9, 2014
Last updated
Jan 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Authorized official

Name
Louis Joseph
Title
VP
Phone
(615) 373-7630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Obstetrics & Gynecology) Physician 207VB0002X NU Primary

Addresses

Primary practice location

315 Elm Street
Ste 310
Caldwell, ID 83605

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4525
Phone (615) 373-7600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140725002340 ID Part B Supplier - Clinic/Group Practice 5799901815 Receives reassigned benefits from 6 practitioners
Practice locations: Meridian, ID; Weiser, ID; Nampa, ID; Emmett, ID; Caldwell, ID; Boise, ID

National Provider Directory

National Provider Directory

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

300 E Jefferson St
Ste 1010
Boise, ID 83712
Phone (208) 336-4141

16458 N Midland Blvd
Nampa, ID 83687
Phone (208) 795-5075

645 E 5th St
Ste Cc
Weiser, ID 83672

Practitioners & affiliated clinicians

Practitioners 61

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.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1245659093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-373-7600",
            "fax_number": "866-346-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ELM STREET",
            "address_2": "STE 310",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-454-2035",
            "fax_number": "208-454-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY MEDICAL GROUP SPECIALTY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7630"
    },
    "taxonomies": [
        {
            "code": "207VB0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; 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.