NPI age
19 years
Enumerated 2006-07-28
● Active Type 2 · Organization
Idaho Independent Mri Llc
Idaho Independent Mri Llc is 1 of 10 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Surbaugh
Owner
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 10 active clinic/center providers in Idaho.
NPI age
19 years
↑ 6 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
562 Shoup Ave W
Twin Falls, ID 833015029
Mailing address
562 Shoup Ave W
Twin Falls, ID 833015029
Authorized official
Frederick L Surbaugh, MD
Owner
📞 2087321205
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Nicole Bartlett, DNP, AGACNP-BC, PNP Nurse Practitioner NPI 1699055491
- Jessica Cornell, MS Counselor NPI 1922994029
- Stephanie Latimer, RN Registered Nurse NPI 1972741882
- Patricia Lincoln, CST Specialist NPI 1922168723
- Dawn Nutting, CADC, CRCS Counselor NPI 1225875198
- Charlene Surbaugh, R.N., F.A. Registered Nurse NPI 1275685356
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 6 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.