NPI age
3 years
Enumerated 2023-01-19
● Active Type 2 · Organization
Subpart
Tellica Imaging, Llc
Tellica Imaging, Llc is 1 of 16 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Vawdrey
Cfo
Last NPPES update
2023-11-20
Source: monthly bulk 2026-05
How this organization compares
Across 16 active clinic/center providers in Idaho.
NPI age
3 years
↓ 15 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 31% of peers with subspecialties
NPI lifetime · 2023 → 2026
2023-01Enumerated in NPPES
2023
2026
Where they practice
Primary practice location
8505 W Overland Rd
Boise, ID 837091644
Mailing address
36 S State St Ste 2200
Salt Lake City, UT 841111470
Authorized official
Mark L Vawdrey
Cfo
📞 8017181642
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Christine Nguyen, DC Chiropractor NPI 1083208862
- Thomas Stinson, CMT Massage Therapist NPI 1598388761
Specialties
-
Clinic/Center PrimaryDefinition to come...
-
RadiologyA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
Subpart of Intermountain Healthcare.
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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.