NPI age
18 years
Enumerated 2007-08-17
● Active Type 2 · Organization
Mountain Telerad, Pllc
Mountain Telerad, Pllc is 1 of 9 radiologic technologist organizations in Idaho.
Primary specialty
Radiologic Technologist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Johnson
Owner
Last NPPES update
2007-08-17
Source: monthly bulk 2026-05
How this organization compares
Across 9 active radiologic technologist providers in Idaho.
NPI age
18 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-08Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
4519 Enterprise Way
Caldwell, ID 83605
Mailing address
141 Victor Gust Dr
Mountain Home, ID 836471654
Authorized official
Micheal Brent Johnson, D.O.
Owner
📞 2084557482
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Christopher Malcom, D.O. Radiology NPI 1447402425
Specialties
-
Radiologic Technologist PrimaryA medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.
Practice context
Multi-provider organization. 1 individual provider 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 →
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