NPIMap

Organization Active NPI

Health West, Inc.

Doing business as Health West Pediatrics and OB/GYN

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
National Provider Identifier
1942772223
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH WEST, INC.
Doing business as
Health West Pediatrics and OB/GYN
Practice address
500 S 11TH Ave Ste 204
Pocatello, ID 83201-4878
Phone
(208) 232-7862
NPI assigned
Dec 26, 2018
Last updated
Mar 26, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH WEST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Authorized official

Name
Mindy Stosich-Benedetti
Title
Ceo
Phone
(208) 232-7862

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

500 S 11TH Ave Ste 204
Pocatello, ID 83201-4878

Mailing address

500 S 11TH Ave Ste 400
Pocatello, ID 83201-4880
Phone (208) 232-7862

Other names 1

  • Health West Pediatrics and OB/GYN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031210000461 ID Part B Supplier - Clinic/Group Practice 4981500931 Receives reassigned benefits from 67 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, ID; Preston, ID; Pocatello, ID; Montpelier, ID; Lava Hot Springs, ID; Downey, ID; Chubbuck, ID; American Falls, ID
O20190329001557 ID Part A Provider - Federally Qualified Health Center (FQHC) 4981500931 Practice locations: Pocatello, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942772223. Details of each certification follow.

Federally qualified health center certification: CCN 131880

Legal name
HEALTH WEST INC
Doing business as
HEALTH WEST PEDIATRICS AND OB/GYN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 3, 2019
Last certification
Apr 3, 2019
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1975 in ID
Enrollment address
500 S 11TH Ave
Ste 204
Pocatello, ID 83201-4878

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Health West45 organizations share this tax ID, including this one
Part of
Health West

Other organizations with this tax ID 44

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

View all 44

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nichole Wortham Individual Corporate OfficerDirector of Revenue Cycle Jun 11, 2020
W-2 Managing EmployeeDirector of Revenue Cycle Jun 11, 2020
Alyson Later Individual W-2 Managing EmployeeCredentialing and Provider Enrollme May 26, 2022
Lori Seaton Individual W-2 Managing EmployeeBehavior Health Program Manager Oct 16, 2009
Alexander Lemmon Individual Corporate OfficerDirector of Operations Mar 1, 2023
Carol Gilbert Individual Corporate OfficerDirector of Credentialing & Contrac Nov 30, 2023
W-2 Managing EmployeeDirector of Credentialing & Contrac Nov 30, 2023
Heather Schaper Individual Corporate OfficerMid-Level Medical Director Sep 13, 2018
W-2 Managing EmployeeMid-Level Medical Director Sep 1, 2009
Amy Wuest Individual Corporate DirectorBoard Member Sep 14, 2022
Doug Mathis Individual Corporate DirectorBoard Member Jul 27, 2015
Iris Buder Individual Corporate DirectorBoard Secretary Nov 23, 2015
Mark T Horrocks Individual Corporate OfficerChief Medical Officer Oct 31, 2002
W-2 Managing EmployeeChief Medical Officer Oct 31, 2002
Larry Burden Individual Corporate DirectorBoard Member Jun 26, 2017
Irene Barrett Individual Corporate DirectorBoard Member Apr 27, 2021
Paul Morgan Individual Corporate OfficerChief Financial Officer Jul 10, 2017
W-2 Managing EmployeeChief Financial Officer Jul 10, 2017
Lyn N McArthur Individual Corporate OfficerBehavioral Health Clinical Director Jul 16, 2013
W-2 Managing EmployeeBehavioral Health Clinical Director Jul 16, 2013
Charles Rizzo Individual Corporate DirectorBoard Member Sep 20, 2022
Amy Tovey Individual Corporate OfficerChief Operations Officer Jul 27, 2015
W-2 Managing EmployeeChief Operations Officer Jul 27, 2015
Adam Waldron Individual Corporate DirectorBoard President Nov 5, 2011
Gloria Whiteside Individual Corporate DirectorBoard Member Sep 22, 2014
Francee Reyes Individual W-2 Managing EmployeeCredentialing and Provider Enrollme Mar 6, 2023
Amelia Murphy Individual Corporate OfficerMedical Staff Coordinator Nov 14, 2015
W-2 Managing EmployeeMedical Staff Coordinator Nov 14, 2015
Brady V Brower Individual Corporate OfficerDirector of Pharmacy Mar 28, 2022
Daniel Davids Individual Corporate DirectorBoard Member Jun 26, 2017
Mindy Stosich-Benedetti Individual Corporate OfficerChief Executive Officer May 15, 2006
W-2 Managing EmployeeChief Executive Officer May 15, 2006
Amber Davis Individual Corporate DirectorBoard Member Jul 31, 2017

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Health West City CenterPocatello, ID, CCN 131884 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1975
Indian Hills ElementaryPocatello, ID, CCN 131887 Federally qualified health center Operational/Managerial Control Apr 11, 2026

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1942772223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 400",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014880",
            "telephone_number": "208-232-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 204",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014878",
            "telephone_number": "208-232-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH WEST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH WEST, INC.",
        "enumeration_date": "2018-12-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "STOSICH-BENEDETTI",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-232-7862"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health West Pediatrics and OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health West Pediatrics and OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.