Sjrmc Interventional Radiology Services LLC

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

Legal business name

SJRMC INTERVENTIONAL RADIOLOGY SERVICES LLC

Practice address

415 6TH St
Lewiston, ID 83501-2431

Phone

(208) 750-7445

Fax

(208) 750-7395

NPI assigned

Aug 12, 2013

Last updated

Mar 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terrance Dillon

Title

Asst Secretary

Phone

(615) 920-7000

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1043744287

  Member Of

  NPD member

Practitioners 1

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.

• John W. Ho, MD

  • Vascular & Interventional Radiology Physician
  • Lewiston, ID
  • NPI 1023096955
  Medicare reassignment NPD

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1982037107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-750-7445",
            "fax_number": "208-750-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJRMC INTERVENTIONAL RADIOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-12",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "ASST SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeb Michael Simpson
• Jennifer Grace Simpson, RN,CBS
• Selena Leanne Skolrud, MS, SLPCF
• Barry A. Smith, D.O.
• Hannah Lorae Smith, BS
• Marion Elizabeth Smith, ARNP
• Phillip Smith

• Neuroradiology Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Neuroradiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.