Tellica Imaging, LLC
NPI 1760197198 · Radiology Clinic/Center · Boise, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Tellica Imaging, LLC is a Radiology Clinic/Center organization in Boise, ID (NPI 1760197198).
Provider details
- NPI number
- 1760197198
- Entity type
- Organization
- Primary specialty
- Radiology Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Intermountain Healthcare
- Organization subpart
- Yes
- Authorized official
- Mark Vawdrey, Cfo(801) 718-1642
Specialties & taxonomies
Ambulatory Health Care Facilities
- Diagnostic Radiology Physician2085R0202X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-01-19
- Last updated
- 2023-11-20
- Certified
- 2023-11-20
Frequently asked questions
- What is Tellica Imaging, LLC's NPI number?
- Tellica Imaging, LLC's National Provider Identifier (NPI) is 1760197198, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Tellica Imaging, LLC?
- Tellica Imaging, LLC is classified in the NPPES registry as Radiology Clinic/Center (Ambulatory Health Care Facilities).
- Where is Tellica Imaging, LLC located?
- Tellica Imaging, LLC's practice location on file with NPPES is 8505 W Overland Rd, Boise, ID 83709-1644.
- What is Tellica Imaging, LLC's phone number?
- The practice phone number listed in the NPPES registry for Tellica Imaging, LLC is (208) 417-5100.
- Does Tellica Imaging, LLC accept Medicare?
- Tellica Imaging, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Tellica Imaging, LLC?
- The authorized official listed on Tellica Imaging, LLC's NPPES record is Mark Vawdrey, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Tellica Imaging, LLC's NPI active?
- Yes — Tellica Imaging, LLC's NPI (1760197198) is active in the NPPES registry as of the last update on 2023-11-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.