NPIMap

Organization Active NPI

Innovative Health Care Concepts Inc

  • Primary Care Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1861035248
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
INNOVATIVE HEALTH CARE CONCEPTS INC
Practice address
115 E 16TH St
Idaho Falls, ID 83404-5919
Phone
(208) 523-6727
Fax
(208) 523-6729
NPI assigned
Oct 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Authorized official

Name
Mrs. Lisa Michelle Smith
Title
Program Director
Phone
(208) 523-1130

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

115 E 16TH St
Idaho Falls, ID 83404-5919

Mailing address

111 E 16TH St
Idaho Falls, ID 83404-5919
Phone (208) 523-1130

Other identifiers 1

IdentifierTypeStateIssuer
2741600MedicaidID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address counseling@ihccinc.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Innovative Health Care Concepts Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

115 E 16th St
Idaho Falls, ID 83404
Phone (208) 523-1130

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1861035248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 16TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045919",
            "telephone_number": "208-523-1130",
            "fax_number": "208-529-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 16TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045919",
            "telephone_number": "208-523-6727",
            "fax_number": "208-523-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTH CARE CONCEPTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "208-523-1130",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2741600",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "counseling@ihccinc.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "115 E 16th St",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834045919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Jun 2, 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.