ASHTON MEMORIAL, INC. — NPI 1003907163 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1003907163

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

101YM0800X (CMS E2)

Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor

Box 32 Service Location & ZIP+4

2935 ROLLANDET ST, IDAHO FALLS, ID, 83402-4654

✓ 9-Digit EDI 837 ZIP+4 (83402-4654)

Practice Phone & Referral Fax

(208) 542-2905

Fax: (208) 522-2427

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003907163 (ASHTON MEMORIAL, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003907163` (NPI-2 Organization / Facility)
Provider / Legal Name	ASHTON MEMORIAL, INC.
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor NUCC Code: `101YM0800X` (Counselor, Mental Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2935 ROLLANDET ST, IDAHO FALLS, ID, 83402-4654
Practice Telephone / Fax	Tel: (208) 542-2905 \| Fax: (208) 522-2427
Administrative Mailing Address	PO BOX 838, ASHTON, ID, 83420-0838
Enumeration & Last Sync	Enumerated: 2006-09-27 \| CMS Record Updated: 2020-08-22
Authorized Official	SHEILA KELLOGG (Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2935 ROLLANDET ST, IDAHO FALLS, ID, 83402-4654

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Plain-English Taxonomy & CMS Crosswalk (101YM0800X)

What Does Taxonomy Code 101YM0800X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YM0800X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E2 (Mental Health Counselor)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor, Mental Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ASHTON MEMORIAL, INC.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ASHTON MEMORIAL, INC. (NPI #1003907163)