NPIMap

Organization Active NPI

West Valley Medical Group LLC

  • Internal Medicine Physician
  • Caldwell, ID
National Provider Identifier
1871673798
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEST VALLEY MEDICAL GROUP LLC
Doing business as
West Valley Medical Group LLC
Practice address
1906 Fairview Ave Ste 230
Caldwell, ID 83605-5432
Phone
(208) 459-4667
Fax
(208) 442-6520
NPI assigned
Oct 16, 2006
Last updated
Jan 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Authorized official

Name
Louis Joseph
Title
VP
Phone
(615) 373-7630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1906 Fairview Ave Ste 230
Caldwell, ID 83605-5432

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4525
Phone (615) 373-7600

Other identifiers 2

IdentifierTypeStateIssuer
807655500MedicaidID
807981600MedicaidID

Other names 1

  • West Valley Medical Group LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000567 ID Part B Supplier - Clinic/Group Practice 8729180310 Receives reassigned benefits from 12 practitioners
Practice locations: Nampa, ID; Wilder, ID; Parma, ID; Middleton, ID; Meridian, ID; Idaho Falls, ID; Caldwell, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D0521216West Valley Medical Group1906 Fairview Ave #230, Caldwell, ID 83605Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory

Locations

1906 Fairview Ave
Ste 200
Caldwell, ID 83605
Phone (208) 795-5201

1906 Fairview Ave
Ste 203
Caldwell, ID 83605

1906 Fairview Ave
Ste 230
Caldwell, ID 83605
Phone (208) 795-5201

211 E Logan St
Ste 303
Caldwell, ID 83605
Phone (208) 250-2834

315 E Elm St
Ste 70
Caldwell, ID 83605
Phone (208) 453-4333

745 S Progress Ave
Ste 120
Meridian, ID 83642
Phone (208) 795-5073

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1871673798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-373-7600",
            "fax_number": "866-346-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 230",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055432",
            "telephone_number": "208-459-4667",
            "fax_number": "208-442-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7630"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807655500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807981600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Valley Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Valley Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.