Hyrum Bert Prestwich, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Idaho Falls, ID
NPI 1891314522 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1891314522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 8061678 (ID)
- Practice address
- 3245 Channing Way
Idaho Falls, ID 83404-7536 - Phone
- (208) 227-2790
- NPI assigned
- Apr 13, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Teton Valley Health Care Inc
Madison Memorial Hospital
BMH Inc
Bingham Memorial Hospital
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
- Steele Memorial Medical Center
- Eastern Idaho Regional Medical Center
- Teton Valley Hospital
- Bingham Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241030000703 | ID | Practitioner - Nurse Practitioner | 0446783468 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8061678 | ID | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steele Memorial Medical Center | Current |
Accepting new patients | |
| Teton Valley Health Care Inc | Current |
Accepting new patients | |
| Steele Memorial Medical Center | Current |
Accepting new patients | |
| Teton Valley Health Care Inc | Family Medicine | Current | Accepting new patients |
| Utah Cancer Specialists PC | Medical Oncology | Current |
Accepting new patients |
| Teton Valley Health Care, Inc | Current |
Accepting new patients | |
| Madison Memorial Hospital | Current |
Accepting new patients | |
| Teton Valley Health Care Inc | Family Medicine | Current |
Accepting new patients |
| Utah Cancer Specialists PC | Past |
Accepting new patients |
Locations
283 N 1st St
Driggs, ID 83422
Phone (208) 354-2302
120 E Howard 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
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/d61ab3e4-55bb-4859-99e6-22c413b48f2a/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8061678 | ID | Yes |
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
Other providers in Idaho Falls, ID
- Premium Choice Homecare
- Prescription Center Home Care, LLC
- Prescription Center, LLC
- Prescription Center, LLC
- Prescription Center, LLC
- Anjelica Price
- Cory Evan Price
- Raymond Dale Price
- Wade Kelly Price
- Kevin Prier
All providers in Idaho Falls, ID · Family Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.