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WEST VALLEY MEDICAL GROUP LLC NPI 1871673798


NPI Information

NPI: 1871673798
Provider Name: WEST VALLEY MEDICAL GROUP LLC

Doing Business As: WEST VALLEY MEDICAL GROUP LLC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 13D0521216

Address:
1906 FAIRVIEW AVE STE 230
CALDWELL, ID
ZIP 83605
Phone: (208) 459-4667
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WEST VALLEY MEDICAL GROUP LLC is an internal medicine in Caldwell, ID. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. WEST VALLEY MEDICAL GROUP LLC NPI is 1871673798. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As West Valley Medical Group Llc.

The provider's business location address is:

1906 FAIRVIEW AVE STE 230
CALDWELL, ID
ZIP 83605-432
Phone: (208) 459-4667
Fax: (208) 442-6520

The provider's authorized official is William Tedrick Johnson .
The authorized official title is Group Vp/ao and has the following contact phone number (615) 372-3375.

The CLIA number assigned to this NPI record is 13D0521216 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/16/2006 and was last updated on 10/28/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

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
1807655500MEDICAIDIDAHO
2807981600MEDICAIDIDAHO

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: 11/14/2023

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