NPIMap

Organization Active NPI

Teton Valley Hospital & Surgicenter

  • Home Health Agency
  • Driggs, ID
National Provider Identifier
1770504391
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH-184 Issued in ID
Legal business name
TETON VALLEY HOSPITAL & SURGICENTER
Practice address
120 E Howard St
Driggs, ID 83422-5112
Phone
(208) 354-6317
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Susan Kunz
Title
Chief Executive Officer
Phone
(208) 354-6317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH-184 ID Primary

Addresses

Primary practice location

120 E Howard St
Driggs, ID 83422-5112

Mailing address

120 E Howard St
Driggs, ID 83422-5112
Phone (208) 354-6317

Other identifiers 3

IdentifierTypeStateIssuer
0022800MedicaidID
000010033856OtherIDREGENCE BLUE SHIELD OF ID
02592OtherIDBLUE CROSS OF IDAHO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770504391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E HOWARD ST",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225112",
            "telephone_number": "208-354-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HOWARD ST",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225112",
            "telephone_number": "208-354-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON VALLEY HOSPITAL & SURGICENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUNZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "208-354-6317",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ID",
            "license": "HH-184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010033856",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "02592",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Driggs, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.