NPIMap

Organization Active NPI

Radiology Physicians of Idaho

Doing business as Pocatello Radiology Physicians of Idaho

  • Diagnostic Radiology Physician
  • Pocatello, ID
National Provider Identifier
1952377459
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY PHYSICIANS OF IDAHO
Doing business as
Pocatello Radiology Physicians of Idaho
Practice address
1151 Hospital Way BLDG B
Pocatello, ID 83201
Phone
(208) 233-1187
Fax
(208) 234-3841
NPI assigned
Feb 24, 2006
Last updated
Aug 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Steven A. Larsen, M.D.
Title
President
Phone
(208) 233-1187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

1151 Hospital Way BLDG B
Pocatello, ID 83201

Mailing address

P.O. Box 2580
1151 Hospital Way BLDG B
Pocatello, ID 83201
Phone (208) 233-1187

Other identifiers 1

IdentifierTypeStateIssuer
002473400MedicaidID

Other names 1

  • POCATELLO RADIOLOGY PHYSICIANS OF IDAHO Doing business as

National Provider Directory

National Provider Directory

Locations

115 S 15th Ave
Ste A
Pocatello, ID 83201
Phone (208) 233-7931

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1952377459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2580",
            "address_2": "1151 HOSPITAL WAY BLDG B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-233-1187",
            "fax_number": "208-234-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 HOSPITAL WAY BLDG B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-233-1187",
            "fax_number": "208-234-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY PHYSICIANS OF IDAHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-233-1187",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002473400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POCATELLO RADIOLOGY PHYSICIANS OF IDAHO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.