ROCKY MOUNTAIN WOMENS CLINIC LLC - NPI 1104436195

Q: What is Rocky Mountain Womens Clinic LLC's NPI number?

The NPI number for Rocky Mountain Womens Clinic LLC is 1104436195. It was assigned to this organization in the NPPES registry on August 4, 2020.

Q: What is Rocky Mountain Womens Clinic LLC's specialty?

The primary specialty registered for this NPI is Midwife with taxonomy code 176B00000X.

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About Rocky Mountain Womens Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROCKY MOUNTAIN WOMENS CLINIC LLC (NPI 1104436195) is a healthcare organization registered as a midwife in Idaho Falls, Idaho and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through October 15, 2026 and lists Kylee Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1104436195

Entity TypeOrganization

Primary Taxonomy176B00000X

Legal Business NameROCKY MOUNTAIN WOMENS CLINIC LLC

Location Address2065 E 17TH ST STE AIdaho Falls, ID 83404-8042

Mailing AddressPo Box 2578Idaho Falls, ID 83403-2578 · (208) 497-0541 · Fax (208) 497-0873

Phone(208) 497-0541

Fax(208) 497-0873

Organization SubpartNo

Authorized OfficialKylee JohnsonOwner · (208) 497-0541

Enumeration DateAugust 4, 2020

Last NPPES UpdateNovember 2, 20203 updates tracked since enumeration

NPPES CertifiedNovember 2, 2020

✔ NPI 1104436195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMidwifeOther Service Providers

Taxonomy Code176B00000X

Definition

A Midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling, and support to a woman and her newborn throughout the childbearing cycle. A Midwife is a skilled and independent practitioner who has undergone formalized training. Midwives are not required to be nurses and may be trained via multiple routes of education (apprenticeship, workshop, formal classes, or programs, etc., usually a combination). The educational background requirements and licensing requirements vary by state. The Midwife may or may not be certified by a state or national organization.

Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X

2065 E 17TH ST STE A, Idaho Falls, ID 83404

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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2196423

Rocky Mountain Women's Clinic · Idaho Falls, ID

Active · expires Oct 15, 2026

CLIA Number13D2196423

Laboratory TypePhysician Office

Certificate Effective DateOctober 16, 2024

Certificate Expiration DateOctober 15, 2026

Laboratory DirectorKylee Dee Johnson Aprn

Laboratory Phone(208) 497-0541

Laboratory LocationRocky Mountain Women's Clinic2065 E 17th St Ste A, Idaho Falls, ID 83404

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN MCBRIDE

Nurse Practitioner (Family)