Portneuf River Center

Primary specialty

Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X

Legal business name

PORTNEUF RIVER CENTER

Practice address

427 N Arthur Ave Ste B
Pocatello, ID 83204-3006

Phone

(208) 233-2998

Fax

(208) 232-0881

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Kathleen Werner-Leap, CNS, NPP

Title

Director

Phone

(208) 233-2998

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1518006113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 N ARTHUR AVE STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043006",
            "telephone_number": "208-233-2998",
            "fax_number": "208-232-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N ARTHUR AVE STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043006",
            "telephone_number": "208-233-2998",
            "fax_number": "208-232-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTNEUF RIVER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "WERNER-LEAP",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-233-2998",
        "authorized_official_credential": "CNS, NPP"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portneuf Medical Center
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• Portneuf Medical Center
• Portneuf Medical Center
• Portneuf Nephrology Center
• Portneuf Valley Dental
• Portneuf Valley Family Center
• Portneuf Valley Family Center
• Portneuf Valley Family Center
• Elizabeth Poteat

• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.