| Health West Preston Clinic | |
|
655 S 4th E Ste 600 Preston ID 83263-1604 | |
| (208) 852-3200 | |
| (208) 852-0517 |
| Full Name | Health West Preston Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 655 S 4th E, Preston, Idaho |
| Authorized Official Name and Position | Mindy Benedetti (CEO) |
| Authorized Official Contact | 2082327862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health West Preston Clinic Po Box 2377 Pocatello ID 83206-2377 Ph: (208) 232-7862 | Health West Preston Clinic 655 S 4th E Ste 600 Preston ID 83263-1604 Ph: (208) 852-3200 |
| NPI Number | 1033595541 |
|---|---|
| Provider Enumeration Date | 08/06/2015 |
| Last Update Date | 08/24/2020 |
| Medicare PECOS PAC ID | 4981500931 |
|---|---|
| Medicare Enrollment ID | O20031210000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033595541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Idaho) | Primary |
| Provider Name | Martha Isabel Buitrago |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356349492 PECOS PAC ID: 7618874645 Enrollment ID: I20031217000447 |
| Provider Name | Dean T Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144252099 PECOS PAC ID: 9830118348 Enrollment ID: I20051114001151 |
| Provider Name | Kim Leon Cox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801848221 PECOS PAC ID: 0547271926 Enrollment ID: I20060523000137 |
| Provider Name | Mark T Horrocks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700885258 PECOS PAC ID: 2961596069 Enrollment ID: I20070920000296 |
| Provider Name | Helene P Edmo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699767004 PECOS PAC ID: 5698865475 Enrollment ID: I20080123000338 |
| Provider Name | Brandon C Mickelsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417987686 PECOS PAC ID: 8022170620 Enrollment ID: I20081216000259 |
| Provider Name | Jared M Price |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093884363 PECOS PAC ID: 3274638655 Enrollment ID: I20081231000459 |
| Provider Name | Patricia S Francisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598890014 PECOS PAC ID: 1850442781 Enrollment ID: I20090706000331 |
| Provider Name | Jonathan M Cree |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144213554 PECOS PAC ID: 5395896120 Enrollment ID: I20090707000689 |
| Provider Name | William M Woodhouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760531859 PECOS PAC ID: 1759432586 Enrollment ID: I20090707000699 |
| Provider Name | Travis D Nielsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730340365 PECOS PAC ID: 1153503107 Enrollment ID: I20110311000304 |
| Provider Name | Lyn N Mcarthur |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952615619 PECOS PAC ID: 6103081534 Enrollment ID: I20120710000005 |
| Provider Name | Erin L Millward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265789044 PECOS PAC ID: 0143471763 Enrollment ID: I20121108000066 |
| Provider Name | Brandi B Karroum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548517972 PECOS PAC ID: 5890946198 Enrollment ID: I20121114000536 |
| Provider Name | Joseph Neil Ragan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659324499 PECOS PAC ID: 4789676636 Enrollment ID: I20130506000432 |
| Provider Name | John A Fenstermaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548581390 PECOS PAC ID: 6002051398 Enrollment ID: I20130709000136 |
| Provider Name | Zachary B Warnock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164717419 PECOS PAC ID: 9234384579 Enrollment ID: I20130729000563 |
| Provider Name | Kendra J Westerhaus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366750929 PECOS PAC ID: 2668609272 Enrollment ID: I20131205000806 |
| Provider Name | Zuzana Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902234701 PECOS PAC ID: 2365666989 Enrollment ID: I20150313001978 |
| Provider Name | Amanda Meierhoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750552428 PECOS PAC ID: 0648597641 Enrollment ID: I20150401001815 |
| Provider Name | Verena Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255614434 PECOS PAC ID: 9739354903 Enrollment ID: I20150917001748 |
| Provider Name | Doty Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477856847 PECOS PAC ID: 5991014821 Enrollment ID: I20151015002423 |
| Provider Name | Jacob Comstock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386039675 PECOS PAC ID: 9537479423 Enrollment ID: I20151104002900 |
| Provider Name | Shannon Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184917346 PECOS PAC ID: 6002118486 Enrollment ID: I20151230002695 |
| Provider Name | Melissa Kjos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164861340 PECOS PAC ID: 1052553518 Enrollment ID: I20160707002196 |
| Provider Name | Laurie A Nate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851581524 PECOS PAC ID: 3173605235 Enrollment ID: I20160727000360 |
| Provider Name | Michael Ludwig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972892537 PECOS PAC ID: 0840587549 Enrollment ID: I20160923000778 |
| Provider Name | Ana J Weinhold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932369568 PECOS PAC ID: 1951572718 Enrollment ID: I20170213002667 |
| Provider Name | Barbara J Watt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437266251 PECOS PAC ID: 2668771056 Enrollment ID: I20170522001448 |
| Provider Name | Eric Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437531936 PECOS PAC ID: 4385959188 Enrollment ID: I20171215002400 |
| Provider Name | Sulabha Chaganaboyana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659668218 PECOS PAC ID: 8628216330 Enrollment ID: I20171227000740 |
| Provider Name | Brittany E Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780082255 PECOS PAC ID: 4587915442 Enrollment ID: I20180917001543 |
| Provider Name | Dan Lee Park |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639502982 PECOS PAC ID: 0244576510 Enrollment ID: I20190107003200 |
| Provider Name | Gregory Daniel Kostur |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447316799 PECOS PAC ID: 6305985086 Enrollment ID: I20190610001760 |
| Provider Name | Scott Ryan Christensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578719027 PECOS PAC ID: 2961676200 Enrollment ID: I20190730002976 |
| Provider Name | Tina Guedes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194366013 PECOS PAC ID: 2466888748 Enrollment ID: I20200204002993 |
| Provider Name | Adam Hunsaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023626348 PECOS PAC ID: 3577988674 Enrollment ID: I20200806002173 |
| Provider Name | Andrew W Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164952420 PECOS PAC ID: 9931478898 Enrollment ID: I20200807001069 |
| Provider Name | Philip Van De Griend |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275829376 PECOS PAC ID: 1658593827 Enrollment ID: I20211004000969 |
| Provider Name | Angela M Teige |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760913610 PECOS PAC ID: 2668742412 Enrollment ID: I20211007002457 |
| Provider Name | Jessica J Rolynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821652199 PECOS PAC ID: 0042544165 Enrollment ID: I20221012002109 |
| Provider Name | Taylor Augustine |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326544644 PECOS PAC ID: 8729326525 Enrollment ID: I20221121000373 |
| Provider Name | Caroline Sassetti-hryczyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477094498 PECOS PAC ID: 8123491636 Enrollment ID: I20230303001280 |
| Provider Name | Danielle Catalina Richner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316726581 PECOS PAC ID: 0244679272 Enrollment ID: I20240423002979 |
| Provider Name | Jon Malan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306842232 PECOS PAC ID: 6709859903 Enrollment ID: I20240501002959 |
| Provider Name | Steven Miner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508396714 PECOS PAC ID: 3577936822 Enrollment ID: I20240514000800 |
Advanced Dental Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 N 1st E, Preston, ID 83263 Phone: 208-852-0770 Fax: 208-852-3294 | |
Willow Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 47 N 1st E, Preston, ID 83263 Phone: 208-852-2900 Fax: 208-852-3511 | |
Fellows Chiropractic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8 S State St, Preston, ID 83263 Phone: 208-852-2240 | |
Willow Valley Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 47 N 1st E, Preston, ID 83263 Phone: 208-852-0137 Fax: 208-852-3812 | |
Preston Drug Health Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 39 N 1st E, Preston, ID 83263 Phone: 208-852-1563 Fax: 208-852-1268 | |
Preston Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 N 1st E, Preston, ID 83263 Phone: 208-852-3755 Fax: 208-852-3774 |