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MOUNTAIN STATES NEONATOLOGY INC. NPI 1205850823


NPI Information

NPI: 1205850823
Provider Name: MOUNTAIN STATES NEONATOLOGY, INC.
Classification: Pediatrics - 2080N0001X
Entity Type: Organization

Specialization: Neonatal-Perinatal Medicine

Address:
1055 N CURTIS RD
BOISE, ID
ZIP 83706
Phone: (208) 367-7610
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MOUNTAIN STATES NEONATOLOGY, INC. is a neonatal-perinatal medicine pediatrics in Boise, ID. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. MOUNTAIN STATES NEONATOLOGY, INC. NPI is 1205850823. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1055 N CURTIS RD
BOISE, ID
ZIP 83706-309
Phone: (208) 367-7610
Fax: (208) 367-7616

The provider's authorized official is Nanette Sanders .
The authorized official title is Rcm Director and has the following contact phone number (800) 243-3839.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 7/9/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VM0101XObstetrics & GynecologyMaternal & Fetal MedicineNo
22080N0001XPediatricsNeonatal-Perinatal MedicineYes
32080P0203XPediatricsPediatric Critical Care MedicineNo
4363LN0000XNurse PractitionerNeonatalNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1806075900MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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