NPIMap

Individual provider Active NPI

Christopher Ryan Engdahl, DO

  • Emergency Medicine Physician
  • Salmon, ID
National Provider Identifier
1679954275
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
O-1850 Issued in ID
Practice address
203 S Daisy St
Salmon, ID 83467-4709
Phone
(208) 756-5600
NPI assigned
Jun 9, 2015
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O-1850 ID Primary

Addresses

Primary practice location

203 S Daisy St
Salmon, ID 83467-4709

Mailing address

203 S Daisy St
Salmon, ID 83467-4709
Phone (208) 756-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829004335 ID Practitioner - Emergency Medicine 7315232592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steele Memorial Medical CenterGroup PAC ID 9436131265, 25 clinicians

Practice addresses (Care Compare)

203 S Daisy St
Salmon, ID 83467-4709
Phone (208) 756-5600

PO Box
Suite 700
Salmon, ID 83467

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O-1850IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steele Memorial Medical Center CurrentSince Jul 3, 2023 Accepting new patients
Steele Memorial Medical Center CurrentSince Jul 3, 2023 Accepting new patients

Locations

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

Interoperability endpoints

  • Direct secure messaging: cengdahl@shc.gwaydirect.com
  • Direct secure messaging: christopher.engdahl.1@15948.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1679954275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S DAISY ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674709",
            "telephone_number": "208-756-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S DAISY ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674709",
            "telephone_number": "208-756-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGDAHL",
        "first_name": "CHRISTOPHER",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.