Idaho State University Speech & Hearing Clinic | |
650 Memorial Drive, Bldg #68, Pocatello, ID 83201 | |
(208) 282-3495 | |
(208) 282-4571 |
Full Name | Idaho State University Speech & Hearing Clinic |
---|---|
Type | Facility |
Speciality | Audiologist |
Location | 650 Memorial Drive, Pocatello, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952474777 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | (* (Not Available)) | Primary |
235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
Provider Name | Jeff E Brockett |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1013931450 PECOS PAC ID: 0244249589 Enrollment ID: I20060413000305 |
Provider Name | Jennifer E Holst |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1487689683 PECOS PAC ID: 8325057664 Enrollment ID: I20060413000319 |
Provider Name | Deanna C Dye |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1891848347 PECOS PAC ID: 5991804809 Enrollment ID: I20070618000468 |
Provider Name | Michelle M Anderson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922053883 PECOS PAC ID: 4385736420 Enrollment ID: I20070822000355 |
Provider Name | Spencer L Cheshire |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1437320082 PECOS PAC ID: 0547337560 Enrollment ID: I20080917000322 |
Provider Name | Karissa D Miller |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1740436302 PECOS PAC ID: 0446391171 Enrollment ID: I20100104000307 |
Provider Name | Chris A Sanford |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1699869354 PECOS PAC ID: 6305973397 Enrollment ID: I20100422000966 |
Provider Name | Deidra R Nichols |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1225390305 PECOS PAC ID: 8729234240 Enrollment ID: I20120815000458 |
Provider Name | Cindy Seiger |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1548467509 PECOS PAC ID: 5799933925 Enrollment ID: I20121221000102 |
Provider Name | Nancy L Devine |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1548482664 PECOS PAC ID: 2264686898 Enrollment ID: I20130207000534 |
Provider Name | Mary M Whitaker |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1497782577 PECOS PAC ID: 3678719689 Enrollment ID: I20130417000723 |
Provider Name | James E Ralphs |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1427009398 PECOS PAC ID: 7517991730 Enrollment ID: I20130425000101 |
Provider Name | Deborah M Vieira |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1447503024 PECOS PAC ID: 3274562210 Enrollment ID: I20131122000896 |
Provider Name | Corrie E Holmes |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1548548589 PECOS PAC ID: 5890913958 Enrollment ID: I20140902002211 |
Provider Name | Gabriel A Bargen |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1194917567 PECOS PAC ID: 5193810562 Enrollment ID: I20141023002718 |
Provider Name | Lisa Hong |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1295135028 PECOS PAC ID: 8527289701 Enrollment ID: I20141103000616 |
Provider Name | Edward G Smith |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1457502288 PECOS PAC ID: 1850606377 Enrollment ID: I20150812009024 |
Provider Name | Tyler S Burton |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1669003695 PECOS PAC ID: 6002243607 Enrollment ID: I20200317001446 |
Provider Name | Michael Clarke |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1669838736 PECOS PAC ID: 0941591879 Enrollment ID: I20210202000802 |
Provider Name | Kristy D Crownhart |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235654955 PECOS PAC ID: 2264771351 Enrollment ID: I20210729002767 |
Provider Name | Seth Hampton |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1760015366 PECOS PAC ID: 2365846821 Enrollment ID: I20210804004265 |
Provider Name | Brady V Brower |
---|---|
Provider Type | Practitioner - Mass Immunization Roster Biller |
Provider Identifiers | NPI Number: 1568746782 PECOS PAC ID: 8426451121 Enrollment ID: I20210825001024 |
Provider Name | Andrea M Jeffery |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1619647476 PECOS PAC ID: 9638568124 Enrollment ID: I20211123001844 |
Provider Name | Curtis J Billings |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1952609174 PECOS PAC ID: 5395139075 Enrollment ID: I20220222002494 |
Provider Name | Kelly Rojek |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1144847203 PECOS PAC ID: 9436576741 Enrollment ID: I20220414001740 |
Provider Name | Eric C Victor |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1467598581 PECOS PAC ID: 6103917539 Enrollment ID: I20220910000531 |
Provider Name | Shauna L Smith |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1386715696 PECOS PAC ID: 1254716756 Enrollment ID: I20220920002119 |
Provider Name | Jessi E Hardy |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1487377636 PECOS PAC ID: 6103293543 Enrollment ID: I20221027002664 |
Provider Name | Jenna Nicole Raff |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1477283208 PECOS PAC ID: 8820479405 Enrollment ID: I20231024000738 |
Provider Name | Quinlin T Card |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1063895126 PECOS PAC ID: 9133420201 Enrollment ID: I20231212003432 |
Mailing Address | Practice Location Address |
---|---|
Idaho State University Speech & Hearing Clinic 921 S 8th Ave Stop 8116, Pocatello, ID 83209-0002 Ph: (208) 282-3495 | Idaho State University Speech & Hearing Clinic 650 Memorial Drive, Bldg #68, Pocatello, ID 83201 Ph: (208) 282-3495 |
Jeff E Brockett, ED.D Audiologist Medicare: Accepting Medicare Assignments Practice Location: 650 Memorial Dr Bldg 68, Pocatello, ID 83209 Phone: 208-282-2556 | |
Dr. Makenzi Gwinn, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way Ste 115, Pocatello, ID 83201 Phone: 208-239-1960 Fax: 208-478-0076 | |
Mr. Edward Gregory Smith, M.S., CCC-A Audiologist Medicare: Medicare Enrolled Practice Location: 921 S 8th Ave Stop 8116, Pocatello, ID 83209 Phone: 208-282-3495 Fax: 208-282-4571 | |
Dr. Jennifer Holst, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: Idaho State University, 921 S. 8th Stop 8116, Pocatello, ID 83209 Phone: 208-282-3747 | |
Dr. Mary M. Whitaker, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: 650 Memorial Drive, Bldg 68, Pocatello, ID 83209 Phone: 208-282-2190 | |
Lindsay Anne Tucker, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 650 Memorial Dr, Pocatello, ID 83209 Phone: 208-233-4339 | |
Dr. Alisa Vineyard, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: 2350 Via Caporatti Dr, Suite B, Pocatello, ID 83201 Phone: 208-237-5322 |