Integris Integrative Medical Center

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INTEGRIS INTEGRATIVE MEDICAL CENTER

Practice address

3355 S Holmes Ave
Idaho Falls, ID 83404-7981

Phone

(208) 524-1046

NPI assigned

Apr 18, 2011

Organization subpart

No

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

Authorized official

Name

Connie L Safarik

Title

Office Adminstrator

Phone

(208) 524-1046

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303084800000",
    "number": "1306136825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047981",
            "telephone_number": "208-524-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047981",
            "telephone_number": "208-524-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS INTEGRATIVE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A",
        "authorized_official_last_name": "SAFARIK",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE ADMINSTRATOR",
        "authorized_official_telephone_number": "208-524-1046"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.