Reach Primary Care LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

REACH PRIMARY CARE LLC

Doing business as

Reach TeleMed

Practice address

141 N Palmetto Ave Unit 326
Eagle, ID 83616-8014

Phone

(435) 538-3713

NPI assigned

Nov 12, 2021

Last updated

Nov 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thao T Nelson, PANPI 1093084931

Title

Owner

Phone

(435) 538-3713

Specialties & licenses 1

Addresses

Other names 1

• Reach TeleMed Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thao T Nelson, PA-C

  • Medical Physician Assistant
  • Meridian, ID
  • NPI 1093084931
  NPD Authorized official

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636675200000",
    "number": "1740946870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N PALMETTO AVE UNIT 326",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836168014",
            "telephone_number": "435-538-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N PALMETTO AVE UNIT 326",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836168014",
            "telephone_number": "435-538-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REACH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "THAO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-538-3713",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reach TeleMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine Marie Radsma, LM, CPM
• Kimberly Ann Rainey, P.T.
• Renae Ramos, PA-C
• Rebecca L Rand, LCSW
• Jordan Lee Rausch, CGC
• Reach the Summit Language and Literacy Clinic, LLC
• Rebecca Rand Counseling LLC
• Karissa Redd
• Austin M Reed
• Daniel C Reed, MD

• Community Health Clinic/Center in Eagle, ID
• Providers in Eagle, ID by specialty
• Community Health Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.