Unified Healthcare of Idaho LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

UNIFIED HEALTHCARE OF IDAHO LLC

Practice address

2275 W Broadway St Ste G
Idaho Falls, ID 83402-2902

Phone

(208) 529-3967

Fax

(208) 522-0088

NPI assigned

Apr 29, 2015

Last updated

Jul 11, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

TUELLER COUNSELING INCAs reported in NPPES

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

Authorized official

Name

Thomas Tueller, LCSWNPI 1740321314

Title

Owner

Phone

(208) 221-0007

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Tueller Counseling Services

Practitioners 1

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.

• Thomas E. Tueller, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1740321314
  NPD Authorized official

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1588041537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 W BROADWAY ST STE G",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022902",
            "telephone_number": "208-529-3967",
            "fax_number": "208-522-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 W BROADWAY ST STE G",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022902",
            "telephone_number": "208-529-3967",
            "fax_number": "208-522-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIFIED HEALTHCARE OF IDAHO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TUELLER COUNSELING INC",
        "enumeration_date": "2015-04-29",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-221-0007",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "847298396",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Two Hearts Foundation LLC (Amada Senior Care Idaho Falls, ID)
• Yesenia Tyler
• Keisha M Uhl, RBT-21-160654
• William Scott Ulrich, PA
• Tammy Umbra
• Unison Music Therapy LLC
• University of Utah Adult Services (University of Utah Hospital Nephrology Divison)
• University of Utah Adult Services (IDAHO HEART INSTITUTE-Cardiology EP)
• University of Utah Adult Services (Radial First Cardiovascular Associates)
• University of Utah Adult Services (Eastern Idaho Regional MC-Cardiology EP)

• Health Service Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.