| Community Council Of Idaho, Inc | |
|
2100 Alan St Idaho Falls ID 83404-5801 | |
| (208) 528-7655 | |
| (208) 524-9390 |
| Full Name | Community Council Of Idaho, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2100 Alan St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Arnold Cantu (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 2085287655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Council Of Idaho, Inc 2100 Alan St Idaho Falls ID 83404-5801 Ph: (208) 528-7655 | Community Council Of Idaho, Inc 2100 Alan St Idaho Falls ID 83404-5801 Ph: (208) 528-7655 |
| NPI Number | 1710925250 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 6204877467 |
|---|---|
| Medicare Enrollment ID | O20050627001149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710925250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Derek R Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306865464 PECOS PAC ID: 2466359799 Enrollment ID: I20041020000902 |
| Provider Name | Gene K Hodges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316055320 PECOS PAC ID: 0648360727 Enrollment ID: I20071212000722 |
| Provider Name | Teresa Kay Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285642322 PECOS PAC ID: 5496813594 Enrollment ID: I20081112000757 |
| Provider Name | Barry F Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891713178 PECOS PAC ID: 7315000494 Enrollment ID: I20090115000504 |
| Provider Name | Ronald K Sebreros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386901627 PECOS PAC ID: 2062738792 Enrollment ID: I20150224000703 |
| Provider Name | Joshua Stringam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164860078 PECOS PAC ID: 3971731332 Enrollment ID: I20160725002276 |
| Provider Name | Eric F Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083155337 PECOS PAC ID: 2860743564 Enrollment ID: I20201216003069 |
| Provider Name | Craig G Steiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710477500 PECOS PAC ID: 2163821984 Enrollment ID: I20210527003238 |
| Provider Name | Luisa A Hiendlmayr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730474602 PECOS PAC ID: 1254563372 Enrollment ID: I20220427000170 |
| Provider Name | Matthew Widdison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932789260 PECOS PAC ID: 0547669384 Enrollment ID: I20240322004296 |
| Provider Name | William J May |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801037551 PECOS PAC ID: 6002257789 Enrollment ID: I20240513000951 |
| Provider Name | Noemi Rivas Briones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619657020 PECOS PAC ID: 1456893619 Enrollment ID: I20240604001826 |
| Provider Name | Neil K Burraston |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1760131841 PECOS PAC ID: 2466833322 Enrollment ID: I20240719002663 |
| Provider Name | Lilia Chavez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285279141 PECOS PAC ID: 0941741987 Enrollment ID: I20240918001874 |
| Provider Name | Daniel S Felix |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114227055 PECOS PAC ID: 9739610783 Enrollment ID: I20241002001115 |
| Provider Name | Emily Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245989318 PECOS PAC ID: 7618358573 Enrollment ID: I20241030000145 |
Physician Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 | |
Family First Medical Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3614 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-552-7700 Fax: 208-552-1783 | |
Neville Spinal Balance Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2145 West Broadway Street, Idaho Falls, ID 83402 Phone: 208-522-3130 | |
R.k. Arbon, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 Channing Way, Suite 116, Idaho Falls, ID 83404 Phone: 208-529-0575 Fax: 208-528-0223 | |