TETON VALLEY HEALTH CARE INC NPI 1801143029

NPI Information

NPI: 1801143029
Provider Name: TETON VALLEY HEALTH CARE, INC

Doing Business As: VICTOR CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 13D0520979

Address:
83 N MAIN ST
VICTOR, ID
ZIP 83455
Phone: (208) 354-6307
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TETON VALLEY HEALTH CARE, INC is a rural health clinic center in Victor, ID. TETON VALLEY HEALTH CARE, INC NPI is 1801143029. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Victor Clinic.

The provider's business location address is:

83 N MAIN ST
VICTOR, ID
ZIP 83455-368
Phone: (208) 354-6307
Fax: (208) 787-7456

The provider's authorized official is Jill Payne Payne .
The authorized official title is Chief Of Compliance and has the following contact phone number (208) 354-6352.

The CLIA number assigned to this NPI record is 13D0520979 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/7/2012 and was last updated on 2/20/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207LP2900X	Anesthesiology	Pain Medicine		IDAHO	No
2	207Q00000X	Family Medicine			IDAHO	No
3	207X00000X	Orthopaedic Surgery			IDAHO	No
4	207XX0005X	Orthopaedic Surgery	Sports Medicine		IDAHO	No
5	208000000X	Pediatrics			IDAHO	No
6	208600000X	Surgery		31	IDAHO	No
7	208VP0014X	Pain Medicine	Interventional Pain Medicine	31	IDAHO	No
8	261QR1300X	Clinic/Center	Rural Health	31	IDAHO	Yes
9	363AM0700X	Physician Assistant	Medical		IDAHO	No
10	363L00000X	Nurse Practitioner			IDAHO	No
11	363LP0200X	Nurse Practitioner	Pediatrics		IDAHO	No

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: 5/5/2024

NPI Synchronization or Removal

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