NPIMap

Individual provider Active NPI

Hyrum Bert Prestwich, FNP-C

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1891314522
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8061678 Issued in ID
Practice address
3245 Channing Way
Idaho Falls, ID 83404-7536
Phone
(208) 227-2790
NPI assigned
Apr 13, 2020
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8061678 ID Primary

Addresses

Primary practice location

3245 Channing Way
Idaho Falls, ID 83404-7536

Mailing address

3245 Channing Way
Idaho Falls, ID 83404-7536
Phone (208) 227-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030000703 ID Practitioner - Nurse Practitioner 0446783468 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Teton Valley Health Care IncGroup PAC ID 3870744956, shared by 4 NPIs, 31 clinicians
Madison Memorial HospitalGroup PAC ID 4183949522, 20 clinicians
BMH IncGroup PAC ID 8426149758, 137 clinicians
Bingham Memorial HospitalGroup PAC ID 8426955014, 68 clinicians

Practice addresses (Care Compare)

283 N 1St St
Driggs, ID 83422-5109
Phone (208) 354-2302

450 E Main St
Reburg, ID 83440-2048
Phone (208) 359-6516

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
8061678IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Teton Valley Health Care Inc Family Medicine Current Accepting new patients
Teton Valley Health Care, Inc CurrentSince Oct 1, 2025 Accepting new patients
Teton Valley Health Care Inc Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Madison Memorial Hospital CurrentSince Dec 14, 2024 Accepting new patients
Teton Valley Health Care Inc CurrentSince Oct 1, 2025 Accepting new patients
Utah Cancer Specialists PC Medical Oncology CurrentSince Sep 1, 2024 Accepting new patients
Steele Memorial Medical Center CurrentSince Dec 16, 2024 Accepting new patients
Steele Memorial Medical Center CurrentSince Dec 16, 2024 Accepting new patients
Utah Cancer Specialists PC PastSince Nov 30, 2025 Accepting new patients

Locations

120 E Howard St
Driggs, ID 83422
Phone (208) 354-2302

283 N 1st St
Driggs, ID 83422
Phone (208) 354-2302

3245 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2700

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

1121 E 3900 S
Ste C230
Salt Lake City, UT 84124

10808 S River Front Pkwy
Ste 400
South Jordan, UT 84095
Phone (801) 281-6870

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d61ab3e4-55bb-4859-99e6-22c413b48f2a/

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1891314522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047536",
            "telephone_number": "208-227-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047536",
            "telephone_number": "208-227-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTWICH",
        "first_name": "HYRUM",
        "middle_name": "BERT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "8061678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.