GRAND TETON CHILD NEUROLOGY
NPI 1639322258
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Idaho Falls, ID
NPI Status: Active since October 28, 2008
Contact Information
2225 TETON PLZ STE B
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 529-4300
Fax: (208) 529-1627
- Organization
- Psychiatry & Neurology
- Neurology with Special Qualifications in...
- Accepts Insurance
- CLIA Number: 13D2057441
- CLIA Cert. Type: Other - CLINICAL RESEARCH SITE
- CLIA Exp. Date: 04-16-2027
About GRAND TETON CHILD NEUROLOGY
This page provides the complete NPI Profile along with additional information for Grand Teton Child Neurology, a provider established in Idaho Falls, Idaho operating as a Psychiatry & Neurology, focusing in neurology with special qualifications in child neurology . The healthcare provider is registered in the NPI registry with number 1639322258 assigned on October 2008. The practitioner's primary taxonomy code is 2084N0402X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Dr. Peter W Castellanos Md (Neurologist)
- NPI
- 1639322258
- Provider Name
- GRAND TETON CHILD NEUROLOGY
- Entity Type
- Organization
- Location Address
- 2225 TETON PLZ STE B IDAHO FALLS, ID 83404
- Location Phone
- (208) 529-4300
- Location Fax
- (208) 529-1627
- Mailing Address
- 2225 TETON PLZ STE B IDAHO FALLS, ID 83404
- Mailing Phone
- (208) 529-4300
- Mailing Fax
- (208) 529-1627
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-28-2008
- Last Update Date
- 08-17-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology
- Taxonomy Code
- 2084N0402X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251S00000X | Agencies | Community/Behavioral Health |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 807968700 | MEDICAID (05) | ID | |
| 77234 | OTHER (01) | ID | BLUE CROSS OF IDAHO |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D2057441
- Facility Type
- Other - CLINICAL RESEARCH SITE
- Certificate Effective Date
- April 17, 2025
- Certificate Expiration Date
- April 16, 2027
- Laboratory Director
- CLINT E. BEHREND
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Grand Teton Child Neurology to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1639322258, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
IDAHO FALLS, ID 83404
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639322258, enumerated as an "organization" on October 28, 2008.
The provider is located at 2225 TETON PLZ STE B IDAHO FALLS, ID 83404 and the phone number is (208) 529-4300.
Psychiatry & Neurology with taxonomy code 2084N0402X and a focus in Neurology with Special Qualifications in Child Neurology.
The provider might be accepting Accepts: University of Utah Health Plans, Medicare,. Please consult your insurance carrier or call the provider to verify.
