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Contact Information

MOUNTAIN STATES NEONATOLOGY, INC.
1055 N CURTIS RD
BOISE, ID83706-1309
 Phone: 208-367-7610
 Fax: 208-367-7616
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neonatal-Perinatal Medicine

2080N0001X 37 Physician/Pediatric Medicine
 

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
 

Neonatal

363LN0000X 50 Nurse Practitioner
 

Pediatric Critical Care Medicine

2080P0203X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MOUNTAIN STATES NEONATOLOGY, INC.

NPI Number 1205850823
LBN Legal business name MOUNTAIN STATES NEONATOLOGY, INC.
Authorized official NANETTE SANDERS - (RCM DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/27/2006
Last updated 10/23/2024 - More than a year ago
Identifiers
ID Medicaid 806075900
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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