Heather Lin Halversen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

921 S 8TH Ave Stop 8253
Pocatello, ID 83209-0002

Phone

(208) 282-4726

NPI assigned

Jun 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CC Pocatello LLCGroup PAC ID 8527353176, 7 clinicians

Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Community Care West Side LLCGroup PAC ID 3678738218, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• CC Pocatello LLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1538517156
  Medicare reassignment Care Compare group
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment Care Compare group
• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  ID

  Medicare reassignment NPD
• Community Care West Side LLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1295009785
  Care Compare group
• Just 4 Kids Health LLC

  • Urgent Care Clinic/Center
  • Idaho Falls, ID
  • NPI 1043722259
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664064000000",
    "number": "1801526199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3782 E 115 N",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834425613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE STOP 8253",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090002",
            "telephone_number": "208-282-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSEN",
        "first_name": "HEATHER",
        "middle_name": "LIN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-09-25",
        "certification_date": "2022-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danson S. Hall, DPT
• Dominee Rachelle Hall
• Lisa Hall
• Tiffany Marie Hall, PHARMD
• Colleen E. Hallinan, RN-BC
• Hamilton Treatment Associates, LLC
• Patrick Hamilton
• Emma Hammer, MD
• Justin Paul Hammer
• Nathan Hammer, MRO-2433

• Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.