Tea Obs LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

TEA OBS LLC

Practice address

2620 S Eagle Rd
Meridian, ID 83642-6704

Phone

(208) 342-5151

NPI assigned

Sep 5, 2022

Organization subpart

No

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

Authorized official

Name

David Crooke

Title

Administrator

Phone

(208) 342-5151

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1962123315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426704",
            "telephone_number": "208-342-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426704",
            "telephone_number": "208-342-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEA OBS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-05",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "CROOKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-342-5151"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexis S Taylor, DPT
• Michael Binns Taylor, MD
• Nancy Nuce Taylor, NP-C
• Tayla Monique Taylor, LMSW
• Tyler Taysom
• Ashenafi Tefera
• Tegmentum Counseling Services LLC
• Amanda Teich, RD, LD
• Corinne Teigen, LMSW
• Lodaicy E Teldeschi

• Ambulatory Surgical Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.