Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tellica Imaging, LLC

Organization Diagnostic Radiology Physician · NPI 1760197198

Tellica Imaging, LLC is a Diagnostic Radiology Physician in Boise, Idaho. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8505 W Overland Rd
Boise, ID 83709-1644
Phone: (208) 417-5100
Fax: (208) 417-5105
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Radiology Clinic/Center (primary) Taxonomy 261QR0200X
Diagnostic Radiology Physician Taxonomy 2085R0202X

Record details

NPI number1760197198
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationIntermountain Healthcare
Authorized official Mark Vawdrey — Cfo · (801) 718-1642
NPI enumeratedJanuary 19, 2023
Last updated in NPPESNovember 20, 2023
Certification dateNovember 20, 2023
Mailing address36 S State St Ste 2200, Salt Lake City, UT 84111-1470

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