Arthritis Specialty Center,Inc
Organization Active NPI Specialist · Pocatello, ID
NPI 1801989454 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1801989454
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- M8731 (ID)
- Legal business name
- ARTHRITIS SPECIALTY CENTER,INC
- Practice address
- 1448 E Center Street
Suite E
Pocatello, ID 83201 - Phone
- (208) 234-1300
- Fax
- (208) 234-1333
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Ananda Walaliyadda, MD
- Title
- Owner
- Phone
- (208) 234-1300
Practitioners 7
-
Monika Jarzmik, FNP
-
Ananda Walaliyadda, M.D.
-
James L Blaine, P.A.-C
-
Stephen L. Richins, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2027091 | Arthritis Specialty Center | Compliance | Jul 12, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070622000454 | ID | Part B Supplier - Clinic/Group Practice | 3274632807 |
Receives reassigned benefits from 6 practitioners Practice locations: Idaho Falls, ID; Pocatello, ID; Rigby, ID |
National Provider Directory
Locations
352 W Sunnyside Rd
Idaho Falls, ID 83402
Phone (208) 234-1300
1448 E Center St
Ste E
Pocatello, ID 83201
Phone (208) 234-1300
711 Rigby Lake Dr
Ste 1400
Rigby, ID 83442
Phone (208) 234-1300
530 Rigby Lake Dr
Ste 2
Rigby, ID 83442
Phone (208) 232-0452
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BHFAAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | M8731 | ID | Yes |
Addresses
Primary practice location
1448 E Center Street
Suite E
Pocatello, ID 83201
Mailing address
1448 E Center Street
Suite E
Pocatello, ID 83201
Phone (208) 234-1300
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.