Organization Active NPI

Novotelehealth

  • Psychiatry Physician
  • Idaho Falls, ID
National Provider Identifier
1336817444
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NOVOTELEHEALTH
Practice address
329 S Woodruff Ave
Idaho Falls, ID 83401-4322
Phone
(208) 881-0085
Fax
(208) 881-0075
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Jennifer Knutson, LPN
Title
Office Manager
Phone
(208) 881-0085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

329 S Woodruff Ave
Idaho Falls, ID 83401-4322

Mailing address

329 S Woodruff Ave
Idaho Falls, ID 83401-4322
Phone (208) 881-0085

National Provider Directory

National Provider Directory

Locations

329 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 881-0085

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1336817444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014322",
            "telephone_number": "208-881-0085",
            "fax_number": "208-881-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014322",
            "telephone_number": "208-881-0085",
            "fax_number": "208-881-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVOTELEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "KNUTSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-881-0085",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.