Active NPI
Grace Marie Cobiella, M.D.
- Psychiatry Physician
- Idaho Falls, ID
National Provider Identifier
1740325083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M6214
- Practice address
- 3100 Channing Way
Idaho Falls, ID 83404-7533 - Phone
- (208) 227-2100
- Fax
- (208) 227-2361
- NPI assigned
- Feb 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M6214 | ID | Primary |
Addresses
Primary practice location
3100 Channing Way
Idaho Falls, ID 83404-7533
Mailing address
3100 Channing Way
P.O. Box 2077
Idaho Falls, ID 83404-7533
Phone (208) 227-2100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6214 | ID | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740325083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 CHANNING WAY",
"address_2": "P.O. BOX 2077",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047533",
"telephone_number": "208-227-2100",
"fax_number": "208-227-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 CHANNING WAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047533",
"telephone_number": "208-227-2100",
"fax_number": "208-227-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBIELLA",
"first_name": "GRACE",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "M6214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.