Eastern Idaho Intensivist LLC

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

Legal business name

EASTERN IDAHO INTENSIVIST LLC

Practice address

3100 Channing Way
Idaho Falls, ID 83404-7533

Phone

(813) 940-7874

NPI assigned

Jan 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Mit Desai, MD

Title

Ceo

Phone

(813) 530-5043

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1528656659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21647",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336221647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "813-940-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IDAHO INTENSIVIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "MIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-530-5043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Idaho Health Services, Inc.
• Eastern Idaho Health Services, Inc.
• Eastern Idaho Health Services, Inc.
• Eastern Idaho Health Services, Inc.
• Eastern Idaho Health Services, Inc.
• Eastern Idaho Laboratory Consultants LLC
• Eastern Idaho Medical Consultants
• Eastern Idaho Neurological Associates PA
• Eastern Idaho Public Health
• Eastern Idaho Public Health

• Critical Care Medicine (Internal Medicine) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Critical Care Medicine (Internal Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.