Travis Dale Nielsen, DO | |
1951 Bench Rd, Suite B, Pocatello, ID 83201-2073 | |
(208) 238-1000 | |
(208) 238-0009 |
Full Name | Travis Dale Nielsen |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 16 Years |
Location | 1951 Bench Rd, Pocatello, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730340365 | NPI | - | NPPES |
O-0554 | Other | ID | IDAHO BOARD OF MEDICINE REGISTRATION |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | O-0554 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Encompass Health Home Health Of Eastern Idaho | Idaho falls, ID | Home health agency |
Signature Healthcare At Home Of S E Idaho | Chubbuck, ID | Home health agency |
Encompass Hospice Of Idaho | Pocatello, ID | Hospice |
Portneuf Medical Center | Pocatello, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Family Practice Group, P.a. | 1658275391 | 11 |
Health West Inc | 4981500931 | 47 |
Entity Name | Family Practice Group, P.a. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205869310 PECOS PAC ID: 1658275391 Enrollment ID: O20031124000431 |
Entity Name | Health West Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033595541 PECOS PAC ID: 4981500931 Enrollment ID: O20031210000461 |
Entity Name | Pocatello Health Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689802852 PECOS PAC ID: 6608927637 Enrollment ID: O20090701000646 |
Mailing Address | Practice Location Address |
---|---|
Travis Dale Nielsen, DO 1951 Bench Rd, Suite B, Pocatello, ID 83201-2073 Ph: (208) 238-1000 | Travis Dale Nielsen, DO 1951 Bench Rd, Suite B, Pocatello, ID 83201-2073 Ph: (208) 238-1000 |
Shayna Larae Harding, APRN Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1133 Call Creek Dr # A, Pocatello, ID 83201 Phone: 208-232-1000 Fax: 208-232-1006 | |
Cody E Patterson, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 151 N 4th Ave, Pocatello, ID 83201 Phone: 208-269-7147 Fax: 208-416-6522 | |
Dr. Bradley Yamashita Beaufort, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-282-4700 Fax: 208-282-4696 | |
Ryan Hudgens, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 | |
Shaylor Bringhurst, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 | |
Dr. Sharla Clark, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1951 Bench Road, Suite B, Pocatello, ID 83201 Phone: 208-238-1000 Fax: 208-238-0009 | |
Marie Elwood, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 |