EAGLE ROCK REGIONAL NEUROLOGY, P.C.
NPI 1710053756
Psychiatry & Neurology - Neurology in Idaho Falls, ID
NPI Status: Active since November 28, 2006
Contact Information
1995 E 17TH ST
STE 5
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 552-5700
Fax: (208) 552-5703
- Organization
- Psychiatry & Neurology
- Neurology
- CLIA Number: 13D2156813
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 05-05-2027
About EAGLE ROCK REGIONAL NEUROLOGY, P.C.
This page provides the complete NPI Profile along with additional information for Eagle Rock Regional Neurology, P.c., a provider established in Idaho Falls, Idaho operating as a Psychiatry & Neurology, focusing in neurology . The healthcare provider is registered in the NPI registry with number 1710053756 assigned on November 2006. The practitioner's primary taxonomy code is 2084N0400X with license number O343 (ID). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. William Karl Domarad D.o. (Physician)
- NPI
- 1710053756
- Provider Name
- EAGLE ROCK REGIONAL NEUROLOGY, P.C.
- Entity Type
- Organization
- Location Address
- 1995 E 17TH ST STE 5 IDAHO FALLS, ID 83404
- Location Phone
- (208) 552-5700
- Location Fax
- (208) 552-5703
- Mailing Address
- 1995 E 17TH ST STE 5 IDAHO FALLS, ID 83404
- Mailing Phone
- (208) 552-5700
- Mailing Fax
- (208) 552-5703
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-28-2006
- Last Update Date
- 08-22-2020
- 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
- Taxonomy Code
- 2084N0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- O343
- License State
- ID
- Taxonomy Description
- A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| S5247 | OTHER (01) | ID | BLUE CROSS |
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
- 13D2156813
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- May 06, 2025
- Certificate Expiration Date
- May 05, 2027
- Laboratory Director
- SCOTT TAYLOR
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Eagle Rock Regional Neurology, P.c. 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 1710053756, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
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 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710053756, enumerated as an "organization" on November 28, 2006.
The provider is located at 1995 E 17TH ST STE 5 IDAHO FALLS, ID 83404 and the phone number is (208) 552-5700.
Psychiatry & Neurology with taxonomy code 2084N0400X and a focus in Neurology.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
