Individual provider Active NPI

Telietha Ann Hammon, FNP-BC

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1942976592
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
69144 Issued in ID
Practice address
1880 John Adams Pkwy
Idaho Falls, ID 83401-4315
Phone
(208) 524-6633
Fax
(208) 524-9952
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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 69144 ID Primary

Addresses

Primary practice location

1880 John Adams Pkwy
Idaho Falls, ID 83401-4315

Mailing address

1880 John Adams Pkwy
Idaho Falls, ID 83401-4315
Phone (208) 524-6633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929002914 ID Practitioner - Nurse Practitioner 2163829466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

2351 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-7310

2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-4823

2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

3385 Potomac Way
Idaho Falls, ID 83404-4978
Phone (208) 522-7246

380 Walker Dr
Rexburg, ID 83440-1657
Phone (208) 356-9559

Hospital & facility affiliations

  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Aug 1, 2022 Accepting new patients
Wallace C Baker CurrentSince Sep 1, 2021 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

1425 Parkway Dr
Blackfoot, ID 83221
Phone (208) 785-2600

2375 E Sunnyside Rd
Ste B
Idaho Falls, ID 83404
Phone (208) 524-0610

3385 Potomac Way
Idaho Falls, ID 83404
Phone (208) 522-7246

1880 John Adams Pkwy
Idaho Falls, ID 83401
Phone (208) 524-6633

2330 Coronado St
Idaho Falls, ID 83404
Phone (208) 552-1234

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

150 Vista Dr
Pocatello, ID 83201
Phone (208) 232-2146

380 Walker Dr
Ste 100
Rexburg, ID 83440

Organizations & group practices 3

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

Hospital & facility affiliations 2

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1942976592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 JOHN ADAMS PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014315",
            "telephone_number": "208-524-6633",
            "fax_number": "208-524-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 JOHN ADAMS PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014315",
            "telephone_number": "208-524-6633",
            "fax_number": "208-524-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMON",
        "first_name": "TELIETHA",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "69144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.