C Scott Needham MD PLLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

C SCOTT NEEDHAM MD PLLC

Practice address

2805 Valencia Dr
Idaho Falls, ID 83404-7597

Phone

(208) 525-9400

NPI assigned

Nov 2, 2020

Organization subpart

No

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

Authorized official

Name

Charles Scott Needham, MD

Title

Owner

Phone

(406) 690-2008

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1467053090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 VALENCIA DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 VALENCIA DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047597",
            "telephone_number": "208-525-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C SCOTT NEEDHAM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "NEEDHAM",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-690-2008",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063435899",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Christine Buxton, LPC
• Travis Kurt Bybee, LCSW
• Venkata Kalyan C Byrapogu, MD
• Amanda Ruth Byrd, CADC
• Brian W Byrd, PHARMD
• Robert Lee Cach, M.D.
• Jennifer Caillier
• Victoria Zumberge Cain, PT, CWS
• Larry Calabro, LCSW
• Rivani A Calato

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.