NPIMap

Organization Active NPI

Mountain Valley Orthopedics, PA

  • Orthopaedic Surgery Physician
  • White Bird, ID
National Provider Identifier
1558448563
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M-5614 Issued in ID
Legal business name
MOUNTAIN VALLEY ORTHOPEDICS, PA
Practice address
HC 1 Box 85 M
White Bird, ID 83554-9703
Phone
(208) 839-2299
Fax
(208) 839-2858
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Gerald McManus, M.D.
Title
President
Phone
(208) 839-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X M-5614 ID Primary

Addresses

Primary practice location

HC 1 Box 85 M
White Bird, ID 83554-9703

Mailing address

HC 1 Box 85 M
White Bird, ID 83554-9703
Phone (208) 839-2299

Other identifiers 1

IdentifierTypeStateIssuer
1710063698OtherIDPERSONAL NPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558448563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 85 M",
            "city": "WHITE BIRD",
            "state": "ID",
            "postal_code": "835549703",
            "telephone_number": "208-839-2299",
            "fax_number": "208-839-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 85 M",
            "city": "WHITE BIRD",
            "state": "ID",
            "postal_code": "835549703",
            "telephone_number": "208-839-2299",
            "fax_number": "208-839-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VALLEY ORTHOPEDICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-839-2299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M-5614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1710063698",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bird, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.