Eubanks Enterprises Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

EUBANKS ENTERPRISES INC

Practice address

1600 John Adams Pkwy Ste 101
Idaho Falls, ID 83401-4300

Phone

(208) 716-8278

NPI assigned

Sep 27, 2022

Last updated

Sep 27, 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

Derek Eubanks

Title

Owner

Phone

(208) 716-0849

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1538883236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 JOHN ADAMS PKWY STE 101",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014300",
            "telephone_number": "208-716-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 JOHN ADAMS PKWY STE 101",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014300",
            "telephone_number": "208-716-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUBANKS ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-716-0849"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.