Southeastern District Health Dept.

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

SOUTHEASTERN DISTRICT HEALTH DEPT.

Practice address

1901 Alvin Ricken Dr
Pocatello, ID 83201-2727

Phone

(208) 233-9080

Fax

(208) 234-7169

NPI assigned

Apr 15, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tricia Nannette Codding

Title

Fachs Director

Phone

(208) 233-9080

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1396919916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 ALVIN RICKEN DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012727",
            "telephone_number": "208-233-9080",
            "fax_number": "208-234-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 ALVIN RICKEN DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012727",
            "telephone_number": "208-233-9080",
            "fax_number": "208-234-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DISTRICT HEALTH DEPT.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "CODDING",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "NANNETTE",
        "authorized_official_title_or_position": "FACHS DIRECTOR",
        "authorized_official_telephone_number": "208-233-9080",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Idaho Gastroenterology, PLLC
• Southeast Idaho Gastroenterology,PLLC
• Southeast Idaho Orthodontics, PLLC
• Southeastern District Health Department
• Southeastern District Health Department (Southeastern Idaho Public Health)
• Katrina E Spangenberg, MD
• Michael Sparks
• Trevor Sparrow
• Brianna Spaulding, LMSW
• Kelli Spaulding, LMSW

• Public Health or Welfare Agency in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Public Health or Welfare Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.