POCATELLO FAMILY MEDICINE (NPI# 1760739973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760739973 |
| Entity Type | Organization |
| Organization Name | POCATELLO FAMILY MEDICINE |
| Practice Address |
465 Memorial Drive Pocatello ID 83201-4008 |
| Mailing Address |
465 Memorial Dr Pocatello ID 83201-4008 |
| Practice Telephone | 2082824700 |
| Practice Fax Number | 2082824696 |
| Mailing Telephone | 2082824700 |
| Mailing Fax Number | 2082824696 |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |
| Authorized Official Name | ROSE JOHNSON (OFFICE MANAGER) |
| Authorized Official Telephone | 2082824421 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
NP-1199A | ID | Ambulatory Health Care Facilities |
| Street Address |
465 MEMORIAL DRIVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225557341 | Scott Allen | Dentist | 465 Memorial Drive, Pocatello, ID 83209-8008 | 2017-09-11 |
| 1407261407 | Stephen B Grandy | Dentist | 465 Memorial Drive, Pocatello, ID 83209-0000 | 2014-06-27 |
| 1972850444 | Daniel Paul Yates | Dentist | 465 Memorial Drive, Pocatello Family Dentistry, Pocatello, ID 83209-8088 | 2012-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1508875881 | Primary Care Specialists, Pa | Clinic/Center | 110 Vista Drive, Pocatello, ID 83201 | 2006-08-05 |
| 1003231911 | Need-a-nurse Medical Staffing, LLC | Clinic/Center | 476 E Chubbuck Rd, Pocatello, ID 83202-1816 | 2014-02-28 |
| 1275894065 | Alice D. Bollinger | Clinic/Center | 444 Hospital Way, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1700147543 | Becky Lee Morrison | Clinic/Center | 444 Hospital Way, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1245591080 | Colleen E. Hallinan | Clinic/Center | 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1548521396 | Nanette Marie Phinney | Clinic/Center | 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 | 2012-06-07 |
| 1285936781 | Bmh Inc. | Clinic/Center | 2302 E Terry St, Pocatello, ID 83201-2733 | 2010-12-03 |
| 1124355813 | Phs Md #1, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
| 1992032098 | Phs Md #1, LLC | Clinic/Center | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2009-11-10 |
| Find all providers in POCATELLO | ||||
Please comment or provide details below to improve the information on POCATELLO FAMILY MEDICINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.