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EASTERN IDAHO SPINE CENTER
NPI 1154593705
Rehabilitation Practitioner in Idaho Falls, ID

Active since March 24, 2008
2860 CHANNING WAY, STE 112, IDAHO FALLS, ID 83404(208) 535-4343(208) 535-4344 Get Directions Write a Review

NPPES record last updated: June 6, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Eastern Idaho Spine Center NPPES

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

EASTERN IDAHO SPINE CENTER (NPI 1154593705) is a healthcare organization registered as a rehabilitation practitioner in Idaho Falls, Idaho and active in the NPI registry since March 2008. The organization lists Shane Christian Mangrum, Owner, as its authorized official.

NPPES Registry Identity

NPI1154593705
Entity TypeOrganization
Primary Taxonomy225400000X
Legal Business NameEASTERN IDAHO SPINE CENTER
Location Address2860 CHANNING WAY, STE 112Idaho Falls, ID 83404-7531
Mailing Address2860 Channing Way, Ste 112Idaho Falls, ID 83404-7531 · (208) 535-4343 · Fax (208) 535-4344
Phone(208) 535-4343
Fax(208) 535-4344
Organization SubpartNo
Authorized OfficialShane Christian MangrumOwner · (208) 535-4343
Enumeration DateMarch 24, 2008
Last NPPES UpdateJune 6, 2008
✔ NPI 1154593705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225400000X
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
2860 CHANNING WAY, Idaho Falls, ID 83404
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Other Identifiers 1

Medicaid8079840ID

Group Practice 1

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

Other Providers at the Same Location NPPES 20

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

SHANNON JENKINS DO
Pediatrics (Neonatal-Perinatal Medicine)
2860 CHANNING WAY, SUITE 100
IDAHO FALLS, ID 83404
Bonneville County (208) 535-4575
EAST FALLS PLASTIC SURGERY LLC
Plastic Surgery
2860 CHANNING WAY, SUITE 114A
IDAHO FALLS, ID 83404
Bonneville County (208) 535-4565
OMNIFLIGHT HELICOPTERS, INC.
Ambulance (Air Transport)
2860 CHANNING WAY, SUITE 206
IDAHO FALLS, ID 83404
Bonneville County (800) 760-1583
R.K. ARBON, M.D., P.A.
Family Medicine
2860 CHANNING WAY, SUITE 116
IDAHO FALLS, ID 83404
Bonneville County (208) 529-0575
BRANDI JO SMITH APRN-CNP
Nurse Practitioner (Family)
2860 CHANNING WAY, SUITE 115
IDAHO FALLS, ID 83404
Bonneville County (208) 529-7283
TETON PLASTIC SURGERY
Surgery (Plastic and Reconstructive Surgery)
2860 CHANNING WAY, SUITE 213
IDAHO FALLS, ID 83404
Bonneville County (208) 552-1406
MRS. EMILY ANN COWLES R.D.,L.D.
Dietitian, Registered
2860 CHANNING WAY, SUITE 115
IDAHO FALLS, ID 83404
Bonneville County (208) 529-6127
WESTERN CENTER FOR REHABILITATION
Rehabilitation Practitioner
2860 CHANNING WAY, 114
IDAHO FALLS, ID 83404
Bonneville County (208) 535-4343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastern Idaho Spine Center's NPI number?

The NPI number for Eastern Idaho Spine Center is 1154593705. It was assigned to this organization in the NPPES registry on March 24, 2008.

Where is Eastern Idaho Spine Center located?

Eastern Idaho Spine Center is located at 2860 Channing Way Ste 112, Idaho Falls, ID 83404. The listed phone number is (208) 535-4343.

What is Eastern Idaho Spine Center's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

When was this NPI record last updated?

The NPPES record for Eastern Idaho Spine Center was last updated on June 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.