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

Dr. Roderick Jack Willmore, MD

Individual provider Diagnostic Radiology Physician · NPI 1346538253

Dr. Roderick Jack Willmore, MD is a Diagnostic Radiology in Idaho Falls, Idaho. Graduated from Virginia Commonwealth University, School of Medicine in 2011, 15 years ago. Practices with Teton Radiology Caldwell, a 16-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
15
Trained at
Virginia Commonwealth University, School of Medicine
Licensed in
ID
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone: (208) 529-6111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence M13586 (ID)

Record details

NPI number1346538253
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 12, 2011
Last updated in NPPESMay 15, 2017
Mailing address2265 E Sunnyside Rd, Idaho Falls, ID 83404-7598

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolVIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Teton Radiology Caldwell — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations21 on file with Medicare

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