Idaho Psychiatric Institute

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT965 Issued in ID

Legal business name

IDAHO PSYCHIATRIC INSTITUTE

Practice address

1975 Martha Ave
Idaho Falls, ID 83404-7580

Phone

(208) 529-4300

Fax

(208) 529-1627

NPI assigned

Apr 6, 2010

Organization subpart

No

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

Authorized official

Name

Shawn Thurber, PH.D., LMFT

Title

President

Phone

(208) 529-4300

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Idaho Psychiatric Institute2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Idaho Psychiatric Institute

  • Community/Behavioral Health Agency
  • Ammon, ID
  • NPI 1679766562
  NPD tax ID

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1285959908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MARTHA AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047580",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MARTHA AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047580",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO PSYCHIATRIC INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "THURBER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-529-4300",
        "authorized_official_credential": "PH.D., LMFT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808091400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808091300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Home Health & Hospice, Inc.
• Idaho Neurosurgery & Spine PLLC
• Idaho Neurosurgical Center, PA
• Idaho Physician Services Inc.
• Idaho Prosthetics & Orthotics, Inc.
• Idaho Recovery Center, LLC.
• Idaho Surgicenter North LLC
• Idaho Urgent Care
• Idaho Vacation Rentals LLC
• Ideal Solutions, Inc.

• Occupational Therapist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.