Pinnacle Health Systems

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PINNACLE HEALTH SYSTEMS

Practice address

1522 Elk Creek Drive
Idaho Falls, ID 83404

Phone

(208) 552-0920

Fax

(208) 529-2564

NPI assigned

Jun 15, 2006

Last updated

May 6, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donevan B Neider, LCSWNPI 1447294004

Title

Owner

Phone

(208) 552-0920

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Donevan B Neider, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1447294004
  Authorized official Same address or phone

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1275577827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 ELK CREEK DRIVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-552-0920",
            "fax_number": "208-529-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 ELK CREEK DRIVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-552-0920",
            "fax_number": "208-529-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "NEIDER",
        "authorized_official_first_name": "DONEVAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-552-0920",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807134000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Pierce-Schmidt, COTA/L
• Trae Pilster, PA-C
• Tyler James Pincock, BS, LMT
• Justin Pingry
• Richard Pingry
• Sara Pinson, LCPC
• Susannah Lynn Pipkin, LMSW
• Mary Rachel Pirkle, CNM
• Joshua L Pixton, DNP-PMHNP
• Melissa Plaisted, FNP-C

• Psychiatry Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.