INTERMOUNTAIN MEDICAL GROUP, INC – NPI #1356397673
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

INTERMOUNTAIN MEDICAL GROUP, INC is a provider located in KINGSTON, PA. NPPES has assigned the NPI number 1356397673 to INTERMOUNTAIN MEDICAL GROUP, INC on May 26, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 4 years ago on Jan 25, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for INTERMOUNTAIN MEDICAL GROUP, INC below.

NPI Profile for
INTERMOUNTAIN MEDICAL GROUP, INC

NPI Number
1356397673
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
INTERMOUNTAIN MEDICAL GROUP, INC
Primary location
610 WYOMING AVE
KINGSTON, PA 18704-3702
Phone: (570) 288-5441 Fax: (570) 288-5842
Mailing address
4000 MERIDIAN BLVD
FRANKLIN, TN 37067-6325
Phone: (615) 465-7000 Fax: (615) 628-6877
Organization Subpart
No
Authorized Official
JENNIFER JACKSON
SENIOR DIRECTOR PROVIDER ENROLLMENT
Phone: (877) 892-9815
Updated
Certification Date
Jan 25, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for INTERMOUNTAIN MEDICAL GROUP, INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERHIGHMARK BLUE SHIELDPA1624037
OTHERHIGHMARK BLUE SHIELDPW510820
MEDICAIDPA100755627
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.