NPIMap

Organization Active NPI

Magno C. Santos MSN, FNP-C PLLC

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1851998710
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MAGNO C. SANTOS MSN, FNP-C PLLC
Practice address
2300 N Yellowstone Hwy # 104
Idaho Falls, ID 83401-1662
Phone
(208) 538-1963
Fax
(208) 615-8005
NPI assigned
Oct 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Magno C Santos, FNP-CNPI 1881935104
Title
Owner
Phone
(208) 538-1963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2300 N Yellowstone Hwy # 104
Idaho Falls, ID 83401-1662

Mailing address

PO Box 271
Rupert, ID 83350-0271
Phone (208) 936-8206

Other identifiers 1

IdentifierTypeStateIssuer
IDTPID015961MedicaidID

Other names 1

  • SunRise Mobile Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Magno C Santos MSN FNP-C PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2300 N Yellowstone Hwy
#104
Idaho Falls, ID 83401
Phone (208) 538-1963

Practitioners & affiliated clinicians

Practitioners 1

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": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1851998710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833500271",
            "telephone_number": "208-936-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N YELLOWSTONE HWY # 104",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834011662",
            "telephone_number": "208-538-1963",
            "fax_number": "208-615-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNO C. SANTOS MSN, FNP-C PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "MAGNO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-538-1963",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTPID015961",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunRise Mobile Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SunRise Mobile Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.