NPIMap

Organization Active NPI

Midvalley Healthcare PLLC

Doing business as MidValley Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, ID
National Provider Identifier
1346573532
Registry record updated Nov 16, 2021
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
MIDVALLEY HEALTHCARE PLLC
Doing business as
MidValley Healthcare
Practice address
2321 E Gala St Ste 3
Meridian, ID 83642-7692
Phone
(208) 888-5848
Fax
(208) 888-0884
NPI assigned
Sep 7, 2009
Last updated
Nov 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Authorized official

Name
Kristina J Harrington, MDNPI 1407887623
Title
Co-Owner
Phone
(208) 888-5848

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2321 E Gala St Ste 3
Meridian, ID 83642-7692

Mailing address

2321 E Gala St Ste 3
Meridian, ID 83642-7692
Phone (208) 888-5848

Other names 1

  • MidValley Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091022000491 ID Part B Supplier - Clinic/Group Practice 0749327880 Receives reassigned benefits from 17 practitioners
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Locations

303 N Allumbaugh St
Ste 335
Boise, ID 83704
Phone (208) 888-5848

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1252281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1346573532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 E GALA ST STE 3",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427692",
            "telephone_number": "208-888-5848",
            "fax_number": "208-888-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 E GALA ST STE 3",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427692",
            "telephone_number": "208-888-5848",
            "fax_number": "208-888-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDVALLEY HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-07",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "208-888-5848",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MidValley Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.