Teton Microbiology Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TETON MICROBIOLOGY LABORATORY

Practice address

258 N Water Ave
Suite 2
Idaho Falls, ID 83402-4057

Phone

(208) 529-0077

Fax

(208) 522-3797

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Rhyanna Kay Rogers

Title

President Owner

Phone

(208) 529-0077

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1396859567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 N WATER AVE",
            "address_2": "STE. 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024057",
            "telephone_number": "208-529-0077",
            "fax_number": "208-522-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 N WATER AVE",
            "address_2": "SUITE 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024057",
            "telephone_number": "208-529-0077",
            "fax_number": "208-522-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON MICROBIOLOGY LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "RHYANNA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "208-529-0077",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8B164",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "22387",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807270200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teton Counseling Center Inc
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• Teton Home Health, LLC (Avalon Home Health, LLC)
• Teton Hospice
• Teton Hospitalist Services, PLLC
• Teton MRI of Idaho Falls
• Teton Nuclear Medicine Service LLC
• Teton Obstetrics and Gynecology PA
• Teton Oms (Snake River Surgical)
• Teton Outpatient, LLC

• Clinical Medical Laboratory in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Medical Laboratory in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.