NPIMap

Organization Active NPI

MVH PMHS LLC

  • Mental Health Counselor
  • Pocatello, ID
National Provider Identifier
1649704248
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MVH PMHS LLC
Practice address
475 Yellowstone Ave
Ste E
Pocatello, ID 83201-4528
Phone
(208) 232-0021
NPI assigned
Apr 20, 2017
Last updated
Apr 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Ned Hillyard
Title
Chief Compliance Officer
Phone
(208) 709-4571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

475 Yellowstone Ave
Ste E
Pocatello, ID 83201-4528

Mailing address

475 Yellowstone Ave
Ste E
Pocatello, ID 83201-4528
Phone (208) 232-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170901002162 ID Part B Supplier - Clinic/Group Practice 9436422045 Receives reassigned benefits from 6 practitioners
Practice locations: Pocatello, ID

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

475 Yellowstone Ave
Ste E
Pocatello, ID 83201
Phone (208) 232-0021

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1649704248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 YELLOWSTONE AVE",
            "address_2": "STE E",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014528",
            "telephone_number": "208-232-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 YELLOWSTONE AVE",
            "address_2": "STE E",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014528",
            "telephone_number": "208-232-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVH PMHS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "HILLYARD",
        "authorized_official_first_name": "NED",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "208-709-4571"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.