Hyperbaric Centers of Idaho LLC
Organization Active NPI Clinic/Center · Hailey, ID
NPI 1851866545 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1851866545
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- HYPERBARIC CENTERS OF IDAHO LLC
- Practice address
- 613 N River St
Hailey, ID 83333-8438 - Phone
- (208) 720-4603
- NPI assigned
- Oct 9, 2018
- Organization subpart
- No
Authorized official
- Name
- Phil Rainey, CHT, EMT
- Title
- Owner
- Phone
- (208) 720-4603
Practitioners 3
-
Justin J Highhouse, LPC
-
Lydia Jo Missal, LCPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240806003834 | ID | Part B Supplier - Clinic/Group Practice | 9537606660 |
Receives reassigned benefits from 1 practitioner Practice locations: Hailey, ID |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician |
207PE0005X | |||
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
613 N River St
Hailey, ID 83333-8438
Mailing address
721 Hailey Dr
Hailey, ID 83333-8778
Other names
- Hyperbarics of Sun Valley
Other providers in Hailey, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.