Devri Burnell
Individual provider Active NPI Physician Assistant · Rigby, ID
NPI 1700512795 · NPPES record last updated Sep 13, 2023
Key facts
- NPI
- 1700512795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 167 E 1St S
Rigby, ID 83442-1401 - Phone
- (208) 745-8747
- NPI assigned
- Aug 1, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Teton Radiology Diagnostic a Series of Teton Group Enterprise
Mountain View Hospital LLC
Medical Imaging Associates of Idaho Falls Inc
Practice addresses (Care Compare)
2001 S Woodruff Ave
Suite 17
Idaho Falls, ID 83404-6372
Phone (208) 524-7237
2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764
2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700
2327 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 715-5220
2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234
2351 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-7310
2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-4823
2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 715-5220
380 Walker Dr
Rexburg, ID 83440-1657
Phone (208) 356-9559
Hospital & facility affiliations
- Mountain View Hospital
- Eastern Idaho Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230405001838 | ID | Practitioner - Physician Assistant | 5799150736 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain View Hospital LLC | Current |
Accepting new patients | |
| Teton Radiology Madison LLC | Current |
Accepting new patients | |
| Community Care West Side LLC | Current |
Accepting new patients | |
| Mountain View Hospital Physician Organization | Past | Accepting new patients | |
| Medical Imaging Associates of Idaho Falls, Inc | Past |
Accepting new patients | |
| CC Pocatello LLC | Past | Accepting new patients |
Locations
2375 Coronado St
Idaho Falls, ID 83404
Phone (208) 522-4600
765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600
2235 E 25th St
Idaho Falls, ID 83404
Phone (208) 521-7593
2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686
2001 S Woodruff Ave
Ste 17
Idaho Falls, ID 83404
Phone (208) 524-7237
2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448
2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100
1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032
404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770
425 E 4th N
Rexburg, ID 83440
380 Walker Dr
Rexburg, ID 83440
Phone (208) 356-9559
167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
167 E 1St S
Rigby, ID 83442-1401
Mailing address
167 E 1St S
Rigby, ID 83442-1401
Phone (208) 745-8747
Other providers in Rigby, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.