Individual provider Active NPI

Carmen Radford, LNP

  • Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1710352349
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP1660A Issued in ID
Practice address
3652 Washington Pkwy
Idaho Falls, ID 83404-7573
Phone
(208) 419-0593
Fax
(208) 524-1222
NPI assigned
Dec 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP1660A ID Primary

Addresses

Primary practice location

3652 Washington Pkwy
Idaho Falls, ID 83404-7573

Mailing address

3652 Washington Pkwy
Idaho Falls, ID 83404-7573
Phone (208) 419-0593

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160126002417 ID Practitioner - Nurse Practitioner 0648573584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMH IncGroup PAC ID 8426149758, shared by 7 NPIs, 137 clinicians

Practice addresses (Care Compare)

315 W Idaho St
Blackfoot, ID 83221-1711
Phone (208) 782-3990

3456 E 17TH St
Suite 125
Ammon, ID 83406-6759
Phone (208) 529-2828

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP1660AIDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BMH Inc CurrentSince Sep 1, 2018 Accepting new patients
BMH Inc. CurrentSince Sep 1, 2018 Accepting new patients
BMH, Inc. Current Accepting new patients
BMH, Inc. CurrentSince Sep 1, 2018 Accepting new patients
BMH Inc. Past Accepting new patients

Locations

3456 E 17th St
Ste 125B
Ammon, ID 83406
Phone (208) 419-0593

3456 E 17th St
Ste 125
Ammon, ID 83406
Phone (208) 529-2828

1350 Parkway Dr
Ste A
Blackfoot, ID 83221

315 W Idaho St
Blackfoot, ID 83221
Phone (208) 782-3990

98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763

3302 Valencia Dr
Ste 120
Idaho Falls, ID 83404
Phone (208) 535-3635

1740 E 17th St
Idaho Falls, ID 83404
Phone (208) 346-8866

3302 Valencia Dr
Ste 201
Idaho Falls, ID 83404
Phone (208) 524-9400

4750 Yellowstone Ave
Ste A
Pocatello, ID 83202
Phone (208) 233-1720

275 W Locust St
Ste A
Shelley, ID 83274

Interoperability endpoints

  • Direct secure messaging: carmen.radford.1@12399.direct.athenahealth.com
  • Direct secure messaging: carmenradford@bmh.medalliesdirect.net

Organizations & group practices 5

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

Hospital & facility affiliations 4

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": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1710352349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047573",
            "telephone_number": "208-419-0593",
            "fax_number": "208-524-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3652 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047573",
            "telephone_number": "208-419-0593",
            "fax_number": "208-524-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "CARMEN",
        "credential": "LNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP1660A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.