John E Liljenquist, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

M4220 Issued in ID

Practice address

2220 E 25TH St
Idaho Falls, ID 83404-7542

Phone

(208) 522-2996

Fax

(208) 523-6025

NPI assigned

Jul 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.liljenquist@rmdoc.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/FEFDAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rocky Mountain Diabetes and Osteoporosis Center PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Idaho Falls, ID
  • NPI 1336220243
  Medicare reassignment NPD
• RM Lab LLC

  • Clinical Medical Laboratory
  • Idaho Falls, ID
  • NPI 1659301349
  NPD

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

{
    "created_epoch": "1122681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1619977600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047596",
            "telephone_number": "208-522-2996",
            "fax_number": "208-523-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047542",
            "telephone_number": "208-522-2996",
            "fax_number": "208-523-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILJENQUIST",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-30",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ID",
            "license": "M4220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY CONNECTIONS",
            "identifier": "804012300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD OF IDAHO",
            "identifier": "25852",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING CONSULTEC EDS",
            "identifier": "113798100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002530600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110008760",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS OF IDAHO",
            "identifier": "34512",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Life Spring Womens Clinic, P.a.
• Lighthouse Counseling, LLC
• Mariah Darlene Lignell
• Cody Likes
• David Redford Liljenquist, MD
• Johnathan Beau Liljenquist, DO
• Joseph R Liljenquist, MD
• Daniel Lilligren, MD
• Catherine L Linderman, MD
• Carrie Rose Lindley, PHARM D

• Endocrinology, Diabetes & Metabolism Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Endocrinology, Diabetes & Metabolism Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.