Individual provider Active NPI

Michael Terry Hartley, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
National Provider Identifier
1700995909
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-27134 Issued in ID
Practice address
3760 Washington Pkwy
Idaho Falls, ID 83404-7593
Phone
(208) 681-1872
NPI assigned
Aug 30, 2006
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-27134 ID Primary

Addresses

Primary practice location

3760 Washington Pkwy
Idaho Falls, ID 83404-7593

Mailing address

3877 E Pepperwood
Rigby, ID 83442-5696
Phone (208) 681-1872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120516000076 ID Practitioner - Clinical Social Worker 0749442390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-27134IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Jun 26, 2024 Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1700995909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3877 E PEPPERWOOD",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834425696",
            "telephone_number": "208-681-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047593",
            "telephone_number": "208-681-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "MICHAEL",
        "middle_name": "TERRY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-27134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.