Eastern Idaho Cardiology Associates, PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

EASTERN IDAHO CARDIOLOGY ASSOCIATES, PLLC

Practice address

2001 S Woodruff Ave
Suite 12a
Idaho Falls, ID 83404-6374

Phone

(208) 524-2255

Fax

(208) 524-2256

NPI assigned

Jul 26, 2005

Last updated

Jul 21, 2022By 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. Patrick D Gorman, M.D.

Title

Ceo

Phone

(208) 524-2255

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5838/brand/1/csg/1/fhir/r4

Practitioners 3

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.

• Ricky Dwayne Latham, MD

  • Cardiovascular Disease Physician
  • Idaho Falls, ID
  • NPI 1477553139
  NPD (past)
• Andrew J Carter, D.O.

  • Interventional Cardiology Physician
  • Hays, KS
  • NPI 1700859659
  NPD (past)
• Baldwin S. Stutts III, M.D.

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1568561025
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508866260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE",
            "address_2": "SUITE 12A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046374",
            "telephone_number": "208-524-2255",
            "fax_number": "208-524-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE",
            "address_2": "SUITE 12A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046374",
            "telephone_number": "208-524-2255",
            "fax_number": "208-524-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IDAHO CARDIOLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-524-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805326000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Idaho Orthopaedics, PLLC (Liljenquist & Redd Orthopedic Surgery)
• East Idaho Residential Habilitation LLC
• East Idaho Surgical Assisting, LLC
• East Idaho Wound Care LLC
• East Idaho Youth Homes LLC
• Eastern Idaho Chiropractic Clinic PA
• Eastern Idaho Community Action Partnership
• Eastern Idaho Endodontics
• Eastern Idaho Foot Clinic
• Eastern Idaho Health Services Inc (Eastern Idaho Regional Medical Center)

• Cardiovascular Disease Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Cardiovascular Disease Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.