NPIMap

Organization Active NPI

Teton County Hospital District

  • General Practice Physician
  • Driggs, ID
National Provider Identifier
1679859797
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
09-179 Issued in WY
Legal business name
TETON COUNTY HOSPITAL DISTRICT
Practice address
852 Valley Centre Dr
Driggs, ID 83422-5005
Phone
(208) 354-4757
Fax
(307) 354-4758
NPI assigned
Nov 3, 2011
Organization subpart
Yes
Parent organization
TETON COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Authorized official

Name
John J. Kren
Title
Cfo
Phone
(307) 739-7526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 09-179 WY Primary

Addresses

Primary practice location

852 Valley Centre Dr
Driggs, ID 83422-5005

Mailing address

PO Box 4010
Jackson, WY 83001-4010
Phone (307) 739-7391

Other names 1

  • St. John's Four Peaks Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Teton County Hospital Distr

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1679859797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4010",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830014010",
            "telephone_number": "307-739-7391",
            "fax_number": "307-739-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 VALLEY CENTRE DR",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225005",
            "telephone_number": "208-354-4757",
            "fax_number": "307-354-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETON COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2011-11-03",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "KREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-739-7526"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "WY",
            "license": "09-179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. John's Four Peaks Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Driggs, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.