MHP Idaho LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MHP IDAHO LLC

Practice address

1534 Idaho St
Lewiston, ID 83501-2573

Phone

(208) 305-6131

NPI assigned

Feb 3, 2021

Organization subpart

No

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

Authorized official

Name

Megan L Walker

Title

Chief Clinical Officer

Phone

(208) 305-6131

Specialties & licenses 5

Addresses

Other identifiers 2

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1902497795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 IDAHO ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012573",
            "telephone_number": "208-305-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 IDAHO ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012573",
            "telephone_number": "208-305-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHP IDAHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "208-305-6131"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386698322",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861741159",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delia Medlin, PH.D.
• Penny Angela Melder, PHARMD
• Leslie Meredith, LMP
• Jenna Andreas Rashell Messick, MS., CCC-SLP
• Judy A Metelko, CNS,ARNP
• Michael J Baldeck, DO, PLLC
• Michael Kos MD, PS
• Eva Louise Michels, FNP-C
• Gerardo Midence, MD
• Brenden Millard, LMSW

• Clinic/Center in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.