NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Region 7 Amh PSR Rexburg

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rexburg, ID
National Provider Identifier
1316073190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR REXBURG
Practice address
333 Walker Dr
Rexburg, ID 83440-1657
Phone
(208) 359-4751
Fax
(208) 356-5461
NPI assigned
Feb 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Melissa M Bean, MA
Title
Program Manager
Phone
(208) 528-5706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

333 Walker Dr
Rexburg, ID 83440-1657

Mailing address

333 Walker Dr
Rexburg, ID 83440-1657
Phone (208) 359-4751

Other identifiers 3

IdentifierTypeStateIssuer
8073446MedicaidID
000010019479OtherBLUE SHIELD
HW181OtherBLUE CROSS OF IDAHO

National Provider Directory

National Provider Directory
Tax ID family
State of Idaho Dept Health114 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316073190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 WALKER DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401657",
            "telephone_number": "208-359-4751",
            "fax_number": "208-356-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WALKER DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401657",
            "telephone_number": "208-359-4751",
            "fax_number": "208-356-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR REXBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-528-5706",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8073446",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010019479",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "HW181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.