Intermountain Medical Group, Inc is a
Family Medicine based in Kingston, Pennsylvania. Intermountain Medical Group, Inc is licensed to practice in * (Not Available) (license number ) and their current practice location is
610 Wyoming Ave, Kingston, Pennsylvania. It can be reached at their office (for appointments etc.) via phone at
(570) 288-5441.
NPI number for Intermountain Medical Group, Inc is 1356397673 and their current mailing address is 4000 Meridian Blvd, Franklin, Tennessee. Intermountain Medical Group, Inc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1356397673.
Healthcare Provider's Profile
| Full Name | Intermountain Medical Group, Inc |
|---|
| Type | Facility |
|---|
| Speciality | Family Medicine |
|---|
| Location | 610 Wyoming Ave, Kingston, Pennsylvania |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1356397673
- Provider Enumeration Date: 05/26/2006
- Last Update Date: 01/25/2022
Medical Identifiers
Medical identifiers for Intermountain Medical Group, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356397673 | NPI | - | NPPES |
| 100755627 | Medicaid | PA | |
| 1624037 | Other | PA | HIGHMARK BLUE SHIELD |
| 510820 | Other | PW | HIGHMARK BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 207X00000X | Orthopaedic Surgery | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Secondary |
| 208800000X | Urology | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (Pennsylvania) | Secondary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Intermountain Medical Group, Inc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Intermountain Medical Group, Inc
4000 Meridian Blvd,
Franklin, TN 37067-6325
Ph: (615) 465-7000 | Intermountain Medical Group, Inc
610 Wyoming Ave,
Kingston, PA 18704-3702
Ph: (570) 288-5441 |
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