Mountain West Medical Services PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

54169 Issued in ID

Legal business name

MOUNTAIN WEST MEDICAL SERVICES PLLC

Practice address

1067 S Wells St
Suite#110
Meridian, ID 83642-7997

Phone

(208) 229-8739

Fax

(208) 895-8540

NPI assigned

Nov 28, 2016

Last updated

Jul 7, 2023By 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

Dr. John Kenneth McRae, DNP, NPH, BSNNPI 1750838504

Title

Dr. of Nurse Practioner

Phone

(208) 229-8739

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15351/brand/1/csg/1/fhir/r4

Practitioners 1

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.

• John McRae, DNP

  • Family Nurse Practitioner
  • Meridian, ID
  • NPI 1750838504
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1457894339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 S WELLS ST",
            "address_2": "SUITE#110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427997",
            "telephone_number": "208-229-8739",
            "fax_number": "208-895-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 S WELLS ST",
            "address_2": "SUITE#110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427997",
            "telephone_number": "208-229-8739",
            "fax_number": "208-895-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "DR. OF NURSE PRACTIONER",
        "authorized_official_telephone_number": "208-229-8739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, NPH, BSN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ID",
            "license": "54169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlee Motyer, PHARMD
• Mountain Pine Dermatology, PLLC
• Mountain Valley Counseling LLC
• Mountain View Pointe Dental
• Mountain View Surgery Center
• Mountain West Spine LLC
• Mountain West Sport and Spine Physical Therapy LLC
• Hannah Lynn Mower
• Rachael Ann Mower, RN
• Molly Moyer, LPC

• Primary Care Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Primary Care Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.