NPIMap

Organization Active NPI

Elmore Medical Center Hospital District

  • Family Medicine Physician
  • Mountain Home, ID
National Provider Identifier
1831179696
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELMORE MEDICAL CENTER HOSPITAL DISTRICT
Practice address
465 McKenna Dr
Mountain Home, ID 83647-2143
Phone
(208) 587-9703
Fax
(208) 580-9812
NPI assigned
Jan 18, 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
Mr. Greg Mauer
Title
Ceo
Phone
(208) 580-2677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

465 McKenna Dr
Mountain Home, ID 83647-2143

Mailing address

465 McKenna Dr
Mountain Home, ID 83647-2143
Phone (208) 587-9703

Other names 1

  • Trinity Mountain Family Practice Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831179696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 MCKENNA DR",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472143",
            "telephone_number": "208-587-9703",
            "fax_number": "208-580-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MCKENNA DR",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472143",
            "telephone_number": "208-587-9703",
            "fax_number": "208-580-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMORE MEDICAL CENTER HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAUER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-580-2677",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Mountain Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, 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.