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Teton Plastic Surgery

Plastic and Reconstructive Surgery Physician in Idaho Falls, ID · enumerated 2007 · authorized official Jennifer Martin, Office Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1154549616

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Registry record

Entity type Organization (Type 2)
Legal business name Teton Plastic Surgery
Practice address 2860 Channing Way, Suite 213, Idaho Falls, ID, 83404
Fax (208) 552-1416
Enumeration date Apr 23, 2007
Last updated in NPPES Mar 7, 2023

Taxonomy & classification

2086S0122X Plastic and Reconstructive Surgery Physician Allopathic & Osteopathic Physicians · License M-8270 (ID) Primary

Authorized official

Name Jennifer Martin
Title Office Manager

Other identifiers

Identifier Type State Issuer
M-8270 Other ID ID MEDICAL LICENSE
5959620-1205 Other UT UT MEDICAL LICENSE
5959620-8905 Other UT UT ST BOARD OF PHARMACY
6687A Other WY WY MEDICAL LICENSE
CS9201 Other ID ID ST BOARD OF PHARMACY
58MKM02 Other WY WY ST BOARD OF PHARMACY
04232007480947 Other ID DR.MOORE NPI TRCKNG#

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Teton Plastic Surgery?
Teton Plastic Surgery is registered in NPPES as a Plastic and Reconstructive Surgery Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-03-07.