Individual provider Active NPI

Christina S Scanlan, PA-C

  • Physician Assistant
  • Twin Falls, ID
National Provider Identifier
1487906814
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1009 Issued in ID
Practice address
118 9TH Ave N
Twin Falls, ID 83301-6352
Phone
(208) 537-7800
NPI assigned
Oct 9, 2012
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA064678 PA
Physician Assistant 363A00000X PA-1009 ID Primary

Addresses

Primary practice location

118 9TH Ave N
Twin Falls, ID 83301-6352

Mailing address

1834 W 34TH St
Erie, PA 16508-2110
Phone (801) 419-2079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA064678PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
ZXM Psychiatry PC CurrentSince Jan 5, 2025 Accepting new patients
Psychiatric Services Behavioral Health Clinic Inc Past Accepting new patients
Psychiatric Services, PA Past Accepting new patients
Upmc Hamot Past Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

118 9th Ave N
Twin Falls, ID 83301
Phone (208) 357-7800

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1487906814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 W 34TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082110",
            "telephone_number": "801-419-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 9TH AVE N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016352",
            "telephone_number": "208-537-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLAN",
        "first_name": "CHRISTINA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064678",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.