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TELLICA IMAGING, LLC
NPI 1760197198
Clinic/Center - Radiology in Boise, ID

Active since January 19, 2023
8505 W OVERLAND RD, BOISE, ID 83709(208) 417-5100(208) 417-5105 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 20, 2023, Oct 11, 2023, Oct 6, 2023 and 3 more (6 updates tracked since 2023).

About Tellica Imaging, Llc NPPES

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

TELLICA IMAGING, LLC (NPI 1760197198) is a healthcare organization registered as a radiology in Boise, Idaho and active in the NPI registry since January 2023. The organization lists Mark L Vawdrey, Cfo, as its authorized official.

NPPES Registry Identity

NPI1760197198
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NameTELLICA IMAGING, LLC
Location Address8505 W OVERLAND RDBoise, ID 83709-1644
Mailing Address36 S State St Ste 2200Salt Lake City, UT 84111-1470
Phone(208) 417-5100
Fax(208) 417-5105
Organization SubpartYesParent: Intermountain Healthcare
Authorized OfficialMark L VawdreyCfo · (801) 718-1642
Enumeration DateJanuary 19, 2023
Last NPPES UpdateNovember 20, 20236 updates tracked since enumeration
NPPES CertifiedNovember 20, 2023
✔ NPI 1760197198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X
8505 W OVERLAND RD, Boise, ID 83709
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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 2

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

CHRISTINE NGUYEN DC
Chiropractor (Pediatric Chiropractor)
8505 W OVERLAND RD
BOISE, ID 83709
Ada County (208) 306-3757
THOMAS AARON STINSON CMT
Massage Therapist
8505 W OVERLAND RD
BOISE, ID 83709
Ada County (208) 629-1904

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 Tellica Imaging, LLC's NPI number?

The NPI number for Tellica Imaging, LLC is 1760197198. It was assigned to this organization in the NPPES registry on January 19, 2023.

Where is Tellica Imaging, LLC located?

Tellica Imaging, LLC is located at 8505 W Overland Rd, Boise, ID 83709. The listed phone number is (208) 417-5100.

What is Tellica Imaging, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

When was this NPI record last updated?

The NPPES record for Tellica Imaging, LLC was last updated on November 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.