NPIMap

Organization Active NPI

Teton Radiology Madison LLC

  • Body Imaging Physician
  • Rexburg, ID
National Provider Identifier
1407081060
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
Legal business name
TETON RADIOLOGY MADISON LLC
Practice address
425 E 4TH N
Rexburg, ID 83440-5390
Phone
(208) 356-4888
NPI assigned
May 26, 2009
Last updated
Jan 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
John J Strobel, MDNPI 1497834980
Title
VP
Phone
(208) 542-5000

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
Body Imaging Physician 2085B0100X NU Primary

Addresses

Primary practice location

425 E 4TH N
Rexburg, ID 83440-5390

Mailing address

PO Box 30015
Dept 595
Salt Lake City, UT 84130-0015
Phone (800) 475-6236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WY, UT, MT, TX, NV, OH7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20090720000575 ID Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 43 practitioners
Practice locations: Pocatello, ID; Preston, ID; Rexburg, ID; Rupert, ID; Driggs, ID; Salmon, ID; Sandpoint, ID; Soda Springs, ID…
O20231026001090 WY Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 31 practitioners
Practice locations: Riverton, WY; Rock Springs, WY; Rawlins, WY; Lander, WY; Afton, WY
O20231027001781 UT Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 24 practitioners
Practice locations: Providence, UT; Park City, UT; Lehi, UT; Logan, UT
O20231127000172 MT Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 31 practitioners
Practice locations: Deer Lodge, MT
O20240506003406 TX Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 2 practitioners
Practice locations: Corpus Christi, TX; Vidor, TX
O20260109001230 NV Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 1 practitioner
Practice locations: Henderson, NV; Las Vegas, NV
O20260514001222 OH Part B Supplier - Clinic/Group Practice 6901958024 Receives reassigned benefits from 1 practitioner
Practice locations: Dublin, OH

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

424 E 4TH N
Rexburg, ID 83440

2245 N 400 E
Ste 101
North Logan, UT 84341
Phone (435) 752-0223

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1407081060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30015",
            "address_2": "DEPT 595",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300015",
            "telephone_number": "800-475-6236",
            "fax_number": "706-596-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 4TH N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405390",
            "telephone_number": "208-356-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON RADIOLOGY MADISON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "STROBEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "208-542-5000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.