Peak Medical Idaho Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

52 Issued in ID

Legal business name

PEAK MEDICAL IDAHO OPERATIONS LLC

Doing business as

Rexburg Care and Rehabilitation Center

Practice address

660 S 2ND W
Rexburg, ID 83440-2300

Phone

(208) 356-0220

NPI assigned

May 20, 2006

Organization subpart

Yes

Parent organization

PEAK MEDICAL LLCAs reported in NPPES

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

Authorized official

Name

Michael T. Berg

Title

Assistant Secretary

Phone

(505) 468-4752

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Rexburg Care and Rehabilitation Center Doing business as

Member of 1

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

• Sunbridge Healthcare LLC

  • Skilled Nursing Facility
  • Tuscumbia, AL
  • NPI 1285685362

  Member Of

  NPD member

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1659325132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S 2ND W",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402300",
            "telephone_number": "208-356-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 2ND W",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402300",
            "telephone_number": "208-356-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK MEDICAL IDAHO OPERATIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK MEDICAL LLC",
        "enumeration_date": "2006-05-20",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ID",
            "license": "52",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805165000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010013225",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01297",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rexburg Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Panting, M.S., CCC-SLP
• Bryce Parker, OT
• Lori Ann Parker, NP C
• Natalie Parker, PTA
• Daniel Parkinson, DC
• Whitney Pedersen
• Jennifer Peine, LMSW
• Rebecca L Perez, PA-C
• Sheridan Orene Perry, BS
• Angela Peterson, FNP-C

• Skilled Nursing Facility in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Skilled Nursing Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.