NPIMap

Organization Active NPI

Teton Healthcare, Inc.

  • Community Based Hospice Care Agency
  • Caldwell, ID
National Provider Identifier
1750119087
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
TETON HEALTHCARE, INC.
Practice address
211 E Logan St Ste 103
Caldwell, ID 83605-4883
Phone
(208) 455-1990
NPI assigned
Jul 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

211 E Logan St Ste 103
Caldwell, ID 83605-4883

Mailing address

211 E Logan St Ste 103
Caldwell, ID 83605-4883

Other practice location 1

139 N Whitley Dr
Fruitland, ID 83619-2430
Phone (208) 549-2104

Other practice location 2

310 E Main St
Emmett, ID 83617-3034
Phone (208) 365-1693

Other names 1

  • Horizon Hospice West Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240910000639 ID Part A Provider - Hospice 4183856487 Practice locations: Caldwell, ID; Emmett, ID; Fruitland, ID

Hospice certification: CCN 131510

Legal name
TETON HEALTHCARE INC
Doing business as
HORIZON HOSPICE WEST
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 18, 1990
Last certification
Dec 16, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 24, 2013 in NV
Enrollment address
211 E Logan St
Ste 103
Caldwell, ID 83605-4883

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Horizon Hospice WestCCN 131510
Ownership
For-Profit
Certified
Jul 18, 1990
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Cornerstone Healthcare Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2311 Park Ave
Ste 10
Burley, ID 83318
Phone (208) 678-2152

1031 E Main St
Burley, ID 83318
Phone (208) 677-6530

190 W Burnside Ave
Ste D
Chubbuck, ID 83202
Phone (208) 233-2279

310 E Main St
Emmett, ID 83617
Phone (208) 365-1693

314 SW 3rd St
Fruitland, ID 83619
Phone (208) 549-2104

560 N 6th E
Mountain Home, ID 83647
Phone (208) 587-6854

707 N 7th Ave
Ste F
Pocatello, ID 83201
Phone (208) 233-2279

527 Memorial Dr
#B
Pocatello, ID 83201
Phone (208) 233-2279

855 N College Rd
Twin Falls, ID 83301
Phone (208) 733-2840

35 W Idaho St
Weiser, ID 83672
Phone (208) 549-2104

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donna L. Beeson Individual Contracted Managing EmployeeMD; Aug 1, 2024
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Direct Ownership Interest Aug 1, 2024 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector & Sole Board Member Jul 20, 2022
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2024 100%
John J Gochnour Individual Corporate OfficerPresident Jul 11, 2024
Randy Schellhous Individual W-2 Managing EmployeeAd; Aug 1, 2024
Amber Tueller Individual Corporate OfficerSecretary Aug 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Change-of-ownership history 1

DateEventCounterparty
Aug 1, 2024 Change of OwnershipThis provider was the buyer Signature Healthcare at HomeCCN 131510, ID, NPI 1184208589

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1750119087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E LOGAN ST STE 103",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E LOGAN ST STE 103",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054883",
            "telephone_number": "208-455-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 N Whitley Dr",
            "address_purpose": "LOCATION",
            "city": "Fruitland",
            "state": "ID",
            "postal_code": "836192430",
            "country_code": "US",
            "telephone_number": "208-549-2104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 E Main St",
            "address_purpose": "LOCATION",
            "city": "Emmett",
            "state": "ID",
            "postal_code": "836173034",
            "country_code": "US",
            "telephone_number": "208-365-1693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TETON HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Hospice West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Horizon Hospice West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.