| Rehabilitative Health Services | |
|
1675 Curlew Dr Ammon ID 83406-4718 | |
| (208) 523-5319 | |
| Not Available |
| Full Name | Rehabilitative Health Services |
|---|---|
| Speciality | Social Worker |
| Location | 1675 Curlew Dr, Ammon, Idaho |
| Authorized Official Name and Position | Demi Echi-aboli (BILLING DEPARTMENT DIRECTOR) |
| Authorized Official Contact | 2083601038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rehabilitative Health Services Po Box 2106 Idaho Falls ID 83403-2106 Ph: (208) 523-5319 | Rehabilitative Health Services 1675 Curlew Dr Ammon ID 83406-4718 Ph: (208) 523-5319 |
| NPI Number | 1619134277 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Medicare PECOS PAC ID | 3173794187 |
|---|---|
| Medicare Enrollment ID | O20110923000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619134277 | NPI | - | NPPES |
| 1619134277 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brett L Hampton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053683904 PECOS PAC ID: 3971739863 Enrollment ID: I20131125000854 |
| Provider Name | April A Moedl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225346190 PECOS PAC ID: 0446480685 Enrollment ID: I20140307000973 |
| Provider Name | Jefferson H Kraczek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093087033 PECOS PAC ID: 8325266505 Enrollment ID: I20140829001772 |
| Provider Name | Michelle Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386010833 PECOS PAC ID: 8921317868 Enrollment ID: I20151016000073 |
| Provider Name | Kathryn E Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619416674 PECOS PAC ID: 5890062699 Enrollment ID: I20170526001920 |
| Provider Name | David C Homer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649336488 PECOS PAC ID: 6709159650 Enrollment ID: I20170829002042 |
| Provider Name | Tanner M Nielsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346574464 PECOS PAC ID: 0941568547 Enrollment ID: I20180102001770 |
| Provider Name | David Paul Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417443631 PECOS PAC ID: 6507118577 Enrollment ID: I20181003001014 |
| Provider Name | Kristy D Goodson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194156216 PECOS PAC ID: 2163765942 Enrollment ID: I20190517001629 |
| Provider Name | Johnathan Koelsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326409913 PECOS PAC ID: 9931442696 Enrollment ID: I20190521000295 |
| Provider Name | Whitney L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770150484 PECOS PAC ID: 5991101297 Enrollment ID: I20210913001813 |
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