NPI age
18 years
Enumerated 2008-01-17
● Active Type 2 · Organization
Mountain Medical Physician Specialists Of Idaho Pc
Mountain Medical Physician Specialists Of Idaho Pc is 1 of 248 radiology organizations in Idaho.
Primary specialty
Radiology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Davis
Ceo
Last NPPES update
2008-11-12
Source: monthly bulk 2026-05
How this organization compares
Across 248 active radiology providers in Idaho.
NPI age
18 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-01Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
1501 Hiland Ave
Burley, ID 833182682
Mailing address
5444 Green St
Murray, UT 841235632
Authorized official
Clark A Davis
Ceo
📞 8012841705
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Troy Anderson, DPT Physical Therapist NPI 1295881696
- Heather Anthon Speech-Language Pathologist NPI 1023783768
- Erika Bell, MS, RDN, LD Dietitian, Registered NPI 1699347351
- Wayne Blauer, MD Family Medicine NPI 1851334817
- Ronald Campbell, D.O. Family Medicine NPI 1124041116
- Tyler Carlen, DPT Physical Therapist NPI 1053855742
- Susan Clough, MS. CCC-SLP Speech-Language Pathologist NPI 1992071633
- Taryn Collins, DO Emergency Medicine NPI 1194179168
- Scott Cook, APRN-CNP Nurse Practitioner NPI 1184398679
- Cami Dixon, RDN Dietitian, Registered NPI 1679194955
- Frederick Fitts, MD Radiology NPI 1609829613
- Jason Forgeon, MD Emergency Medicine NPI 1952961732
- Vanessa Foster Dietitian, Registered NPI 1700628880
- Leah Garey, MSCCC-SLP Speech-Language Pathologist NPI 1649425653
- Shiloh Gilbert, M.D. Emergency Medicine NPI 1114136132
- Jennifer Hansen, M.S.,CCC-SLP Speech-Language Pathologist NPI 1538432158
- Jeremy Haymore, M.D. Family Medicine NPI 1265547582
- Daniel Henrie, MD Emergency Medicine NPI 1659464394
- Gregory Hepworth, OTR/L Occupational Therapist NPI 1962779629
- Tennille Houston, MHE, RD, LD, CDE Dietitian, Registered NPI 1003996398
Specialties
-
Radiology PrimaryA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.