Individual provider Active NPI

Austin Troy Vanorden, PA

  • Physician Assistant
  • Salmon, ID
National Provider Identifier
1437847662
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2508 Issued in ID
Practice address
805 Main St
Salmon, ID 83467-4316
Phone
(208) 756-6212
NPI assigned
Apr 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2508 ID Primary

Addresses

Primary practice location

805 Main St
Salmon, ID 83467-4316

Mailing address

3400 Merlin Dr
Idaho Falls, ID 83404-7430
Phone (208) 522-0886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726001119 ID Practitioner - Physician Assistant 6901267780 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2508IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steele Memorial Medical Center CurrentSince Jun 1, 2023 Accepting new patients
Steele Memorial Medical Center Past Accepting new patients
Steele Memorial Medical Center PastSince Nov 6, 2022 Accepting new patients

Locations

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

805 Main St
Salmon, ID 83467
Phone (208) 282-3495

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1437847662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MERLIN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047430",
            "telephone_number": "208-522-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MAIN ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674316",
            "telephone_number": "208-756-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANORDEN",
        "first_name": "AUSTIN",
        "middle_name": "TROY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.