TETON RADIOLOGY DIAGNOSTIC, LLC – NPI #1194969725
Radiology

A Radiology doctor of Osteopathy that specializes in Body Imaging.

Health Care Provider Taxonomy Code for Radiology

TETON RADIOLOGY DIAGNOSTIC, LLC is a radiologist located in IDAHO FALLS, ID. NPPES has assigned the NPI number 1194969725 to TETON RADIOLOGY DIAGNOSTIC, LLC on April 27, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085B0100X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Body Imaging

The NPI profile was last updated on Jan 05, 2026. 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 TETON RADIOLOGY DIAGNOSTIC, LLC below.

NPI Profile for
TETON RADIOLOGY DIAGNOSTIC, LLC

NPI Number
1194969725
Enumeration Date

(more than 17 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
TETON RADIOLOGY DIAGNOSTIC, LLC
Primary location
2001 S WOODRUFF AVE STE 17
IDAHO FALLS, ID 83404-6372
Phone: (208) 524-7237 Fax:
Mailing address
PO BOX 30015
DEPT 594
SALT LAKE CITY, UT 84130-0015
Phone: (800) 475-6236 Fax: (706) 596-6712
Organization Subpart
Yes - TETON RADIOLOGY DIAGNOSTIC, LLC is subpart of another organization.
Authorized Official
MICHAEL HODEL
GENERAL MANAGER
Phone: (208) 542-5000
Updated
Certification Date
Jan 05, 2026

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.

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.

Taxonomy Classification / Specialization State License
2085B0100X
- Radiology / Body Imaging (Primary)

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.