NPIMap

Organization Active NPI

Human Dynamics and Diagnostics, LLC

  • Community/Behavioral Health Agency
  • Idaho Falls, ID
National Provider Identifier
1346368198
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HUMAN DYNAMICS AND DIAGNOSTICS, LLC
Practice address
2267 Teton PLZ
Idaho Falls, ID 83404-6486
Phone
(208) 524-4953
Fax
(208) 524-7335
NPI assigned
Mar 27, 2007
Last updated
Apr 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Mellissa Ockerman
Title
Office Manager
Phone
(208) 522-0140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2267 Teton PLZ
Idaho Falls, ID 83404-6486

Mailing address

2267 Teton PLZ
Idaho Falls, ID 83404-6486
Phone (208) 524-4953

Other identifiers 1

IdentifierTypeStateIssuer
806878600MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141215002111 ID Part B Supplier - Clinic/Group Practice 1153644547 Receives reassigned benefits from 13 practitioners
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1346368198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-524-4953",
            "fax_number": "208-524-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-524-4953",
            "fax_number": "208-524-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN DYNAMICS AND DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-04-25",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "OCKERMAN",
        "authorized_official_first_name": "MELLISSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-522-0140"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806878600",
            "state": "ID"
        }
    ],
    "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 Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.