NPIMap

Organization Active NPI

Pocatello Health Services, LLC

  • Psychologist
  • Pocatello, ID
National Provider Identifier
1497051544
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
POCATELLO HEALTH SERVICES, LLC
Practice address
651 Memorial Dr
Pocatello, ID 83201-4071
Phone
(208) 239-1222
NPI assigned
Feb 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
John E. Abreu
Title
Cfo
Phone
(208) 239-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

651 Memorial Dr
Pocatello, ID 83201-4071

Mailing address

PO Box 4168
Pocatello, ID 83205-4168
Phone (208) 239-2065

National Provider Directory

National Provider Directory
Tax ID family
Isu Family Medicine6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1497051544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4168",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054168",
            "telephone_number": "208-239-2065",
            "fax_number": "208-239-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014071",
            "telephone_number": "208-239-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCATELLO HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "ABREU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-239-1000"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.