Pineview Medical LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

PINEVIEW MEDICAL LLC

Practice address

9075 Stoney Creek Rd
Pocatello, ID 83204-7242

Phone

(888) 851-3677

Fax

(888) 851-3671

NPI assigned

Dec 19, 2023

Organization subpart

No

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

Authorized official

Name

Jared Allen

Title

Member

Phone

(801) 643-5057

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1386412245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 N 10800 W",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843379222",
            "telephone_number": "888-851-3677",
            "fax_number": "888-851-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 STONEY CREEK RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832047242",
            "telephone_number": "888-851-3677",
            "fax_number": "888-851-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEVIEW MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-643-5057"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Pocatello, ID by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.