NPIMap

Individual provider Active NPI

Jeremy B Haymore, M.D.

  • Family Medicine Physician
  • Burley, ID
National Provider Identifier
1265547582
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01062477A Issued in IN
Practice address
1501 Hiland Ave
Burley, ID 83318-2682
Phone
(208) 677-6440
Fax
(208) 677-6455
NPI assigned
Aug 19, 2006
Last updated
Jun 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01062477A IN Primary

Addresses

Primary practice location

1501 Hiland Ave
Burley, ID 83318-2682

Mailing address

1501 Hiland Ave
Burley, ID 83318-2682
Phone (208) 677-6440

Other identifiers 1

IdentifierTypeStateIssuer
200832230MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000788 ID Practitioner - Emergency Medicine 6709989387 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minidoka Memorial HospitalGroup PAC ID 7315908894, 38 clinicians
Physicians Immediate Care of Twin Falls PAGroup PAC ID 0143460717, 9 clinicians

Practice addresses (Care Compare)

1224 8TH St
Rupert, ID 83350-1527
Phone 20843604813167

1252 Bennett Ave
Suite B
Burley, ID 83318-2664
Phone (208) 647-0656

243 Cheney Dr W
Suite 200
Twin Falls, ID 83301-4278
Phone (208) 736-7422

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01062477AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 1, 2008 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2008 Accepting new patients
Physicians Immediate Care of Twin Falls PA Family Medicine CurrentSince Nov 1, 2016 Accepting new patients
Minidoka Memorial Hospital Family Medicine CurrentSince Mar 6, 2023 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Dec 25, 2023 Accepting new patients
North Canyon Medical Center Inc. Current Accepting new patients
Minidoka Memorial Hospital CurrentSince Mar 6, 2023 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Dec 25, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Emergency Physicians of Delaware County, P.C. Past Accepting new patients

Locations

1252 Bennett Ave
#B
Burley, ID 83318
Phone (208) 647-0656

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

1224 8th St
Rupert, ID 83350
Phone (208) 434-8236

243 Cheney Dr W
#200
Twin Falls, ID 83301
Phone (208) 647-0656

Interoperability endpoints

  • Direct secure messaging: jeremy.haymore.1@29843.direct.athenahealth.com
  • Direct secure messaging: jhaymore637630@direct.ochin.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1265547582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-677-6440",
            "fax_number": "208-677-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-677-6440",
            "fax_number": "208-677-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYMORE",
        "first_name": "JEREMY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01062477A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200832230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

Verify at the official NPI Registry.