Grand Teton Gastroenterology

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GRAND TETON GASTROENTEROLOGY

Practice address

2770 Cortez Ave
Idaho Falls, ID 83404-7590

Phone

(208) 522-4000

Fax

(208) 528-4242

NPI assigned

Feb 28, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa Dawn Lemons, CCS-P

Title

Billing Manager

Phone

(208) 528-4255

Specialties & licenses 1

Addresses

Other names 1

• Digestive Health Center Former legal business name

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clint E Behrend, M.D.

  • Gastroenterology Physician
  • Idaho Falls, ID
  • NPI 1538138243
  NPD
• Paul M Hendrix, M.D.

  • Gastroenterology Physician
  • Idaho Falls, ID
  • NPI 1649249947
  NPD
• Todd A Williams, M.D.

  • Gastroenterology Physician
  • Idaho Falls, ID
  • NPI 1437128733
  NPD

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1457520900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047590",
            "telephone_number": "208-522-4000",
            "fax_number": "208-528-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047590",
            "telephone_number": "208-522-4000",
            "fax_number": "208-528-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TETON GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "LEMONS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "208-528-4255",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCS-P"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Digestive Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sara Graham, RN
• Zebulon C Graham, PHARMD
• Grand Teton Child Neurology
• Grand Teton Chiropractic, P.C.
• Grand Teton Chiropractic, PLLC
• Grand Teton Gastroenterology, PA
• Grand Teton Service Group
• Grand Teton Service Group
• Grand Teton Service Group
• Grand Teton Surgical Center LLC

• Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.